NPI | 1073091336 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: TX 1038056) |
Additional Taxonomies | 163W00000X Registered Nurse (Licence: TX 855511) |
Enumeration Date | 2018-07-30 |
Last Update Date | 2025-05-14 |