| NPI | 1588532519 |
|---|---|
| Entity Type | Individual |
| Gender | N/A |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 163W00000X Registered Nurse (Licence: AZ RN130284) |
| Additional Taxonomies | 363LN0000X Nurse Practitioner, Neonatal (Licence: AZ 334382) |
| Enumeration Date | 2025-10-29 |
| Last Update Date | 2026-02-02 |