| NPI | 1285157024 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 363LN0000X Nurse Practitioner, Neonatal (Licence: MO 2017024741)  | 
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: KS 77768)  | 
| Enumeration Date | 2017-07-24 | 
| Last Update Date | 2017-07-24 |