| NPI | 1164776415 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 363LN0000X Nurse Practitioner, Neonatal (Licence: MO 2013000714) | 
| Additional Taxonomies | 363LN0000X Nurse Practitioner, Neonatal (Licence: KS 75692) | 
| Enumeration Date | 2012-11-07 | 
| Last Update Date | 2020-11-10 |