| NPI | 1578258877 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: IL 209029829) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: IL 041566358) |
| 163WP0200X Registered Nurse, Pediatrics (Licence: OH RN.451803) | |
| Enumeration Date | 2023-04-11 |
| Last Update Date | 2024-06-13 |