| NPI | 1114611555 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LN0000X Nurse Practitioner, Neonatal (Licence: MO 2025009329) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: KS F07231070) |
| Enumeration Date | 2023-06-07 |
| Last Update Date | 2025-04-30 |