| NPI | 1417431248 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: IL 209016660) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: IL 041432646) |
| Enumeration Date | 2018-09-18 |
| Last Update Date | 2018-09-18 |