| NPI | 1235252982 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: TX 1096404) |
| Additional Taxonomies | 363LP0200X Nurse Practitioner, Pediatrics (Licence: MO RN 131621) |
| Enumeration Date | 2007-04-09 |
| Last Update Date | 2023-08-15 |