| NPI | 1598130379 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: IL 277.000802) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: IL 209.013346) |
| Enumeration Date | 2015-12-05 |
| Last Update Date | 2021-01-26 |