| NPI | 1457080897 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner Family (Licence: UT 10637956-4405) |
| Additional Taxonomies | 363LP0200X Nurse Practitioner Pediatrics (Licence: UT 10637956-4405) |
| Enumeration Date | 2022-06-09 |
| Last Update Date | 2022-10-20 |