| NPI | 1972979409 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: IL 277000861) |
| Additional Taxonomies | 163WP0807X Registered Nurse, Psych/Mental Health, Child & Adolescent (Licence: IL 209.012584) |
| 363LP0200X Nurse Practitioner, Pediatrics (Licence: IL 209.012584) | |
| Enumeration Date | 2015-08-19 |
| Last Update Date | 2022-10-07 |