| NPI | 1033780119 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: UT 8433368-4405) | 
| Additional Taxonomies | 2088P0231X Urology, Pediatric Urology (Licence: UT 8433368-4405) | 
| Enumeration Date | 2021-07-08 | 
| Last Update Date | 2021-12-20 |