| NPI | 1710755111 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: IL 209.029558) |
| Additional Taxonomies | 163WP0200X Registered Nurse, Pediatrics (Licence: IL 041.487063) |
| 2080P0006X Pediatrics, Developmental - Behavioral Pediatrics (Licence: IL 209.029558) | |
| 363LF0000X Nurse Practitioner, Family (Licence: IL 209.029558) | |
| Enumeration Date | 2023-12-14 |
| Last Update Date | 2024-07-10 |