| NPI | 1811635212 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0222X Nurse Practitioner, Pediatrics, Critical Care (Licence: KY 3017992) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
| 163WP0200X Registered Nurse, Pediatrics (Licence: KY 1144366) | |
| Enumeration Date | 2022-05-25 |
| Last Update Date | 2022-08-18 |