| NPI | 1124860036 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: TX 1216062) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: UT 9408923-3102) |
| Enumeration Date | 2024-06-11 |
| Last Update Date | 2025-10-27 |