| NPI | 1386958783 |
|---|---|
| Entity Type | Individual |
| Gender | N/A |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LN0000X Nurse Practitioner, Neonatal (Licence: NY F350402) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: NY 613527) |
| Enumeration Date | 2010-07-28 |
| Last Update Date | 2016-12-27 |