| NPI | 1750796249 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: IL 209014456) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: OH COA.15797-NP) |
| Enumeration Date | 2014-06-24 |
| Last Update Date | 2018-03-17 |