| NPI | 1750379046 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: KY 3004588) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: KY 1103542) |
| Enumeration Date | 2005-10-11 |
| Last Update Date | 2014-09-04 |