| NPI | 1154033397 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: UT 9758183-4405)  | 
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program | 
| Enumeration Date | 2022-12-19 | 
| Last Update Date | 2023-10-03 |