| NPI | 1083504807 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: TX 1209604) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: TX 603276) |
| 363LP0200X Nurse Practitioner, Pediatrics (Licence: TX 202529595) | |
| Enumeration Date | 2025-07-03 |
| Last Update Date | 2025-08-28 |