| NPI | 1043278690 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 363LN0000X Nurse Practitioner, Neonatal (Licence: MO 093576)  | 
| Additional Taxonomies | 363LN0000X Nurse Practitioner, Neonatal (Licence: KS 45154)  | 
| 363LN0000X Nurse Practitioner, Neonatal (Licence: KS 14-55049-092)  | |
| Enumeration Date | 2006-05-03 | 
| Last Update Date | 2007-07-08 |