| NPI | 1770067563 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: IL 209.018200) |
| Additional Taxonomies | 163WP0200X Registered Nurse, Pediatrics (Licence: IL 041.393830) |
| Enumeration Date | 2018-09-18 |
| Last Update Date | 2018-09-18 |