NPI | 1558834739 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: IL 209020349) |
Additional Taxonomies | 163W00000X Registered Nurse (Licence: NY 710967) |
363L00000X Nurse Practitioner (Licence: CA 95019727) | |
363LP0200X Nurse Practitioner, Pediatrics (Licence: NY 382916) | |
Enumeration Date | 2019-01-09 |
Last Update Date | 2023-04-14 |