NPI | 1760870307 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: KY 3010614) |
Additional Taxonomies | 363LP0200X Nurse Practitioner, Pediatrics (Licence: OH COA.16907-NP) |
Enumeration Date | 2015-01-06 |
Last Update Date | 2023-07-27 |