| NPI | 1376364638 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: TX 1250109) |
| Additional Taxonomies | 363LP0200X Nurse Practitioner, Pediatrics (Licence: TN 41573) |
| Enumeration Date | 2024-10-21 |
| Last Update Date | 2026-09-22 |