| NPI | 1538234158 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0200X Nurse Practitioner Pediatrics (Licence: UT 355669-4405) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner Family (Licence: UT 355669-4405) |
| Enumeration Date | 2006-11-21 |
| Last Update Date | 2022-07-21 |