| NPI | 1023651247 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: IL 209.024235041.441413) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: IL 041-441413) |
| Enumeration Date | 2019-10-21 |
| Last Update Date | 2021-10-26 |