| 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 |