| NPI | 1043972821 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: UT 318482-4405) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: UT 318482-3102) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2021-10-09 |
| Last Update Date | 2022-03-23 |