| NPI | 1801556055 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 363LN0000X Nurse Practitioner, Neonatal (Licence: GA RN290181) | 
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: GA RN290181) | 
| Enumeration Date | 2021-12-28 | 
| Last Update Date | 2022-05-25 |