| NPI | 1710258314 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: WI 9817-33) |
| Additional Taxonomies | 363LN0000X Nurse Practitioner Neonatal (Licence: MA RN2285105) |
| Enumeration Date | 2012-01-13 |
| Last Update Date | 2021-11-22 |