| NPI | 1801821210 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: KY 4385P) |
| Additional Taxonomies | 363LP0200X Nurse Practitioner, Pediatrics (Licence: MD R134424) |
| Enumeration Date | 2006-07-12 |
| Last Update Date | 2008-09-18 |