| NPI | 1124076880 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LN0000X Nurse Practitioner Neonatal (Licence: MO 2006004075) |
| Additional Taxonomies | 363LN0000X Nurse Practitioner Neonatal (Licence: KS 14-97276-081) |
| 363LN0000X Nurse Practitioner Neonatal (Licence: KS 45844) | |
| Enumeration Date | 2006-05-05 |
| Last Update Date | 2007-07-08 |