| NPI | 1104229590 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: IL 209011956) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: IL 041353464) |
| Enumeration Date | 2014-09-30 |
| Last Update Date | 2014-09-30 |