| NPI | 1801275144 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: IL 209.18828) |
| Additional Taxonomies | 2080H0002X (Licence: IA C145682) |
| 363LP0200X Nurse Practitioner, Pediatrics (Licence: NM CNP-02374) | |
| 363LP0200X Nurse Practitioner, Pediatrics (Licence: IA C145682) | |
| Enumeration Date | 2015-05-19 |
| Last Update Date | 2019-02-20 |