| NPI | 1609125186 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: IL 209009717) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: IL 209009717) |
| Enumeration Date | 2012-08-30 |
| Last Update Date | 2020-05-06 |