| NPI | 1699085365 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: KY 3006513) |
| Additional Taxonomies | 363LP0200X Nurse Practitioner, Pediatrics (Licence: KY 6513P) |
| Enumeration Date | 2010-10-15 |
| Last Update Date | 2021-09-03 |