| NPI | 1558898510 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: IL 209015873) |
| Additional Taxonomies | 363LP0200X Nurse Practitioner, Pediatrics (Licence: MO 2017000683) |
| Enumeration Date | 2017-05-20 |
| Last Update Date | 2017-05-20 |