| NPI | 1861490138 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: IL 209-015320) |
| Additional Taxonomies | 163WP0200X Registered Nurse, Pediatrics (Licence: NM R45506) |
| 363LP0200X Nurse Practitioner, Pediatrics (Licence: FL 9244538) | |
| Enumeration Date | 2005-07-12 |
| Last Update Date | 2017-04-11 |