| NPI | 1013491059 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: IL 209.018061) |
| Additional Taxonomies | 363LP0200X Nurse Practitioner, Pediatrics (Licence: IL 277.002143) |
| 163W00000X Registered Nurse (Licence: IL 041.412825) | |
| Enumeration Date | 2018-09-15 |
| Last Update Date | 2026-04-27 |