| NPI | 1386085967 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: IL 209012768) |
| Additional Taxonomies | 363LP0200X Nurse Practitioner, Pediatrics (Licence: MO 2013024325) |
| 363LP0200X Nurse Practitioner, Pediatrics (Licence: KS 5376028022) | |
| Enumeration Date | 2013-07-11 |
| Last Update Date | 2022-04-04 |