| NPI | 1902357106 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: NY 383024) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: IL 041.447168) |
| 363LP0200X Nurse Practitioner, Pediatrics (Licence: IL 209.014967) | |
| Enumeration Date | 2016-10-23 |
| Last Update Date | 2021-08-13 |