| NPI | 1902553415 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: KY 3017507) |
| Additional Taxonomies | 363LP0222X Nurse Practitioner, Pediatrics, Critical Care (Licence: KY 3017507) |
| Enumeration Date | 2022-03-04 |
| Last Update Date | 2022-03-21 |