| NPI | 1487075305 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: IL 209.012897) |
| Additional Taxonomies | 363LP0200X Nurse Practitioner, Pediatrics (Licence: TN 18596) |
| 163WP0200X Registered Nurse, Pediatrics (Licence: TN 199590) | |
| 163WP0200X Registered Nurse, Pediatrics (Licence: IL 041.430842) | |
| Enumeration Date | 2013-12-18 |
| Last Update Date | 2015-06-30 |