| NPI | 1720240914 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LN0000X Nurse Practitioner, Neonatal (Licence: MO 2001026744) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: IL 209.005689) |
| Enumeration Date | 2008-06-28 |
| Last Update Date | 2021-06-04 |