| NPI | 1962554238 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 163WS0200X Registered Nurse, School (Licence: KY 1027430) |
| Additional Taxonomies | 363LP0200X Nurse Practitioner, Pediatrics (Licence: KY 576P) |
| Enumeration Date | 2007-01-17 |
| Last Update Date | 2007-07-08 |