| NPI | 1942381652 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: KY 3003061) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: KY 3003061) |
| Enumeration Date | 2006-10-18 |
| Last Update Date | 2022-09-21 |