| NPI | 1619644861 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: IL 209-023848) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: IL 209.023848) |
| Enumeration Date | 2021-08-25 |
| Last Update Date | 2024-10-03 |