| NPI | 1861861445 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP0222X Nurse Practitioner, Pediatrics, Critical Care (Licence: IL 209.016222) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: IL 41.390603) |
| 363LF0000X Nurse Practitioner, Family (Licence: IL 209.016222) | |
| 363LF0000X Nurse Practitioner, Family (Licence: TX AP137341) | |
| 363LP0222X Nurse Practitioner, Pediatrics, Critical Care (Licence: TX AP137341) | |
| Enumeration Date | 2015-09-24 |
| Last Update Date | 2021-10-25 |