| NPI | 1104312362 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: TX API137983) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: TX AP137983) |
| Enumeration Date | 2018-07-10 |
| Last Update Date | 2022-05-18 |