| NPI | 1225521396 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP0200X Nurse Practitioner Pediatrics (Licence: AZ 305084) |
| Additional Taxonomies | 363LP0200X Nurse Practitioner Pediatrics (Licence: TX AP135127) |
| Enumeration Date | 2018-06-12 |
| Last Update Date | 2024-07-16 |