| NPI | 1619265659 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0200X Nurse Practitioner Pediatrics (Licence: IL 209008881) |
| Additional Taxonomies | 363LP0200X Nurse Practitioner Pediatrics (Licence: MI 4704298000) |
| Enumeration Date | 2011-07-12 |
| Last Update Date | 2017-03-06 |