| NPI | 1083447791 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: TX 1166379) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: TX 1166379) |
| Enumeration Date | 2024-08-20 |
| Last Update Date | 2025-01-02 |