| NPI | 1154962900 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: WI 13360-33) |
| Additional Taxonomies | 363LP0200X Nurse Practitioner, Pediatrics (Licence: IL 209.019989) |
| Enumeration Date | 2019-10-02 |
| Last Update Date | 2022-12-09 |