NPI | 1003152778 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: IL 209010059) |
Additional Taxonomies | 163W00000X Registered Nurse (Licence: IL 041363279) |
Enumeration Date | 2012-12-27 |
Last Update Date | 2012-12-27 |