| NPI | 1700302494 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LN0000X Nurse Practitioner Neonatal (Licence: CA 95006025) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: MA CNP-COND2374209) |
| 363L00000X Nurse Practitioner (Licence: MI 4704398142) | |
| Enumeration Date | 2017-08-15 |
| Last Update Date | 2024-02-06 |