| NPI | 1518509777 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: KY 3013869) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: MT 173292) |
| 363LN0000X Nurse Practitioner, Neonatal (Licence: KY 3013869) | |
| Enumeration Date | 2019-10-09 |
| Last Update Date | 2021-02-18 |