| NPI | 1124660667 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: IL 209020372) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: MI 041486106) |
| Enumeration Date | 2019-10-16 |
| Last Update Date | 2019-11-02 |