| NPI | 1972768422 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: KY 3005509) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: KY 3005509) |
| Enumeration Date | 2008-07-24 |
| Last Update Date | 2022-04-06 |