| NPI | 1245304534 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: IL 209008728) |
| Additional Taxonomies | 363LP0200X Nurse Practitioner, Pediatrics (Licence: MN 20061649) |
| Enumeration Date | 2006-11-20 |
| Last Update Date | 2011-07-07 |