| NPI | 1023789583 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: NC 5016271) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: IL 209021881) |
| 363LF0000X Nurse Practitioner, Family (Licence: MI 4704317104) | |
| 363LF0000X Nurse Practitioner, Family (Licence: WI 11024) | |
| 363LP0200X Nurse Practitioner, Pediatrics (Licence: IL 209021881) | |
| 363LP0200X Nurse Practitioner, Pediatrics (Licence: MI 4704317104) | |
| 363LP0222X Nurse Practitioner, Pediatrics, Critical Care (Licence: WI 259319-30) | |
| 363LP0222X Nurse Practitioner, Pediatrics, Critical Care (Licence: WI 11024) | |
| Enumeration Date | 2021-09-24 |
| Last Update Date | 2022-11-08 |