NPI | 1104331099 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: UT 9143503-4405) |
Additional Taxonomies | 163WD0400X Registered Nurse, Diabetes Educator (Licence: UT 9143503-3102) |
Enumeration Date | 2017-12-13 |
Last Update Date | 2023-06-21 |