| NPI | 1104455633 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: GA RN301093) |
| Additional Taxonomies | 163WP0200X Registered Nurse, Pediatrics (Licence: IL 041422092) |
| Enumeration Date | 2020-04-06 |
| Last Update Date | 2021-05-20 |