| NPI | 1104353937 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: TX 1106612) |
| Additional Taxonomies | 363LP0200X Nurse Practitioner, Pediatrics (Licence: FL Arnp9321237) |
| 363LP0200X Nurse Practitioner, Pediatrics (Licence: MA RN2375770) | |
| 363LP0200X Nurse Practitioner, Pediatrics (Licence: CA 95025203) | |
| Enumeration Date | 2017-05-11 |
| Last Update Date | 2023-05-30 |