NPI | 1336604644 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: IL 209018362) |
Additional Taxonomies | 163W00000X Registered Nurse (Licence: WA RN60905606) |
163W00000X Registered Nurse (Licence: IL 041465583) | |
363LP0200X Nurse Practitioner, Pediatrics (Licence: WA AP60916521) | |
Enumeration Date | 2019-01-31 |
Last Update Date | 2020-05-28 |