| NPI | 1457820292 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MO 2005019254) |
| Additional Taxonomies | 163WN0002X Registered Nurse, Neonatal Intensive Care (Licence: MO 2005019254) |
| Enumeration Date | 2018-11-22 |
| Last Update Date | 2019-08-11 |