| NPI | 1649903188 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: IL 209.025172) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: IL 209.025172) |
| 2088P0231X Urology, Pediatric Urology (Licence: IL 209.025172) | |
| 363LA2100X Nurse Practitioner, Acute Care (Licence: IL 209.025172) | |
| Enumeration Date | 2022-07-01 |
| Last Update Date | 2022-10-24 |