| NPI | 1659855385 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: WI 9502) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: IL 041470355) |
| 363LP0200X Nurse Practitioner, Pediatrics (Licence: IL 209018201) | |
| Enumeration Date | 2018-09-19 |
| Last Update Date | 2019-10-30 |