| NPI | 1760807176 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: MO 2014004555) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: MO 2007019579) |
| 163W00000X Registered Nurse (Licence: IL 041406061) | |
| Enumeration Date | 2014-02-21 |
| Last Update Date | 2022-05-19 |