| NPI | 1124818836 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: TX 1215534) |
| Additional Taxonomies | 163WP0200X Registered Nurse, Pediatrics (Licence: MA RN2390986) |
| Enumeration Date | 2025-05-07 |
| Last Update Date | 2026-06-11 |