| NPI | 1215536271 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: TX 10200575) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: TX F10200575) |
| Enumeration Date | 2020-10-21 |
| Last Update Date | 2022-11-10 |