| NPI | 1376197129 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: SC 23163) |
| Additional Taxonomies | 363LN0000X Nurse Practitioner Neonatal (Licence: SC AG07190133) |
| Enumeration Date | 2019-07-30 |
| Last Update Date | 2019-10-09 |