NPI | 1972278620 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LP0200X Nurse Practitioner Pediatrics (Licence: IL 209023783) |
Additional Taxonomies | 163W00000X Registered Nurse (Licence: IL 041512404) |
Enumeration Date | 2021-08-14 |
Last Update Date | 2021-08-14 |