| NPI | 1194374314 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: IL 209.019712) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: SC 29296) |
| Enumeration Date | 2019-09-10 |
| Last Update Date | 2022-11-28 |