| NPI | 1407804354 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 363LN0000X Nurse Practitioner, Neonatal (Licence: MO 096906) | 
| Additional Taxonomies | 363LN0000X Nurse Practitioner, Neonatal (Licence: KS 14-822262-012) | 
| 363LN0000X Nurse Practitioner, Neonatal (Licence: KS 44879) | |
| Enumeration Date | 2006-05-04 | 
| Last Update Date | 2007-07-08 |