| NPI | 1063151330 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0200X Nurse Practitioner Pediatrics (Licence: IL 209032039) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner Family (Licence: IL 209032039) |
| 363LF0000X Nurse Practitioner Family (Licence: WI 11997-33) | |
| Enumeration Date | 2022-06-03 |
| Last Update Date | 2025-06-10 |