| NPI | 1659820280 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: IL 209.014848) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: IL 041.414190) |
| Enumeration Date | 2016-09-23 |
| Last Update Date | 2018-10-25 |