NPI | 1174890362 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LA2100X Nurse Practitioner, Acute Care (Licence: IL 209-009224) |
Additional Taxonomies | 363LP0200X Nurse Practitioner, Pediatrics (Licence: IL 209-009224) |
363LP0200X Nurse Practitioner, Pediatrics (Licence: MA RN2374194) | |
Enumeration Date | 2011-11-16 |
Last Update Date | 2025-09-29 |