| NPI | 1154898450 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: TX AP139485) |
| Additional Taxonomies | 363LP0200X Nurse Practitioner, Pediatrics (Licence: LA 245109) |
| Enumeration Date | 2018-10-25 |
| Last Update Date | 2026-01-22 |