| NPI | 1184340523 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: TX 1096617) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: TX 1096617) |
| 363LP0200X Nurse Practitioner, Pediatrics (Licence: TX 1096617) | |
| Enumeration Date | 2022-10-18 |
| Last Update Date | 2024-07-10 |