| NPI | 1992094627 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: CA 95003684) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: IL 209008577) |
| Enumeration Date | 2011-04-04 |
| Last Update Date | 2017-03-28 |