| NPI | 1114637790 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: TX 1104878) |
| Additional Taxonomies | 363LP0200X Nurse Practitioner, Pediatrics (Licence: TX pending) |
| Enumeration Date | 2022-12-05 |
| Last Update Date | 2024-05-15 |