| NPI | 1770839318 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: IL 209009854) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: IL 041328800) |
| Enumeration Date | 2012-08-01 |
| Last Update Date | 2019-03-12 |