| NPI | 1104250216 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: FL APRN9221626) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: TX 1059428) |
| 363LF0000X Nurse Practitioner, Family (Licence: TX 1059428) | |
| 363LF0000X Nurse Practitioner, Family (Licence: FL APRN9221626) | |
| Enumeration Date | 2013-08-26 |
| Last Update Date | 2025-01-29 |