| NPI | 1255766135 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: NY 383321) |
| Additional Taxonomies | 363LP0200X Nurse Practitioner, Pediatrics (Licence: TX 763936) |
| 363LP0200X Nurse Practitioner, Pediatrics (Licence: TX AP123979) | |
| Enumeration Date | 2013-09-10 |
| Last Update Date | 2023-04-18 |