| NPI | 1962445643 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 363LN0005X Nurse Practitioner, Neonatal, Critical Care (Licence: KS 14-72650-112)  | 
| Additional Taxonomies | 363LN0005X Nurse Practitioner, Neonatal, Critical Care (Licence: MO 115266)  | 
| Enumeration Date | 2006-06-13 | 
| Last Update Date | 2007-07-08 |