| NPI | 1124176441 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 163W00000X Registered Nurse (Licence: IL 041-302529) |
| Additional Taxonomies | 363LP0200X Nurse Practitioner, Pediatrics (Licence: IL 209-003684) |
| Enumeration Date | 2007-01-05 |
| Last Update Date | 2007-07-08 |