| NPI | 1780164574 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: IL 209017558) |
| Additional Taxonomies | 2084N0400X Psychiatry & Neurology, Neurology (Licence: IL 209017558) |
| 363LF0000X Nurse Practitioner, Family (Licence: IL 209017558) | |
| Enumeration Date | 2018-08-21 |
| Last Update Date | 2018-08-21 |