NPI | 1417645656 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: UT 14067982-4405) |
Additional Taxonomies | 163WP0200X Registered Nurse, Pediatrics (Licence: UT 10380554-3102) |
Enumeration Date | 2023-04-26 |
Last Update Date | 2025-02-12 |