| NPI | 1609844281 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: IL 209016503) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: KY 4784P) |
| 363LP0200X Nurse Practitioner, Pediatrics (Licence: KY 3004784P) | |
| Enumeration Date | 2006-03-09 |
| Last Update Date | 2022-07-21 |