| NPI | 1134891591 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: UT 12165075-4405) |
| Additional Taxonomies | 363LP0200X Nurse Practitioner, Pediatrics (Licence: UT 12165075-4405) |
| Enumeration Date | 2021-10-04 |
| Last Update Date | 2025-11-17 |