NPI | 1184388621 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: TX 1156708) |
Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: MO 2021034987) |
Enumeration Date | 2021-10-29 |
Last Update Date | 2025-01-14 |