| NPI | 1881562122 |
|---|---|
| Entity Type | Individual |
| Gender | N/A |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LN0000X Nurse Practitioner, Neonatal (Licence: MO 2025040150) |
| Additional Taxonomies | 363LN0000X Nurse Practitioner, Neonatal (Licence: KS 5384848081) |
| Enumeration Date | 2025-10-28 |
| Last Update Date | 2025-10-30 |