| NPI | 1164827242 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: IL 209012323) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: IL 209012323) |
| 363LP0200X Nurse Practitioner, Pediatrics (Licence: MO 2018043672) | |
| Enumeration Date | 2014-10-30 |
| Last Update Date | 2025-05-16 |