| NPI | 1942502612 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: WI 12260-33) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: IL 041.389592) |
| 163W00000X Registered Nurse (Licence: WI 163094-030) | |
| 363LP0200X Nurse Practitioner, Pediatrics (Licence: IL 209.010138) | |
| Enumeration Date | 2010-11-30 |
| Last Update Date | 2023-09-07 |