| NPI | 1396469839 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: TX 1086582) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: TX 891800) |
| Enumeration Date | 2022-09-28 |
| Last Update Date | 2024-11-21 |