| NPI | 1538896907 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: TX 1171097) | 
| Additional Taxonomies | 163WP0200X Registered Nurse, Pediatrics (Licence: AZ RN198962) | 
| 163WP0200X Registered Nurse, Pediatrics (Licence: IL 041.459753) | |
| 363LP0200X Nurse Practitioner, Pediatrics (Licence: IL 209.025986) | |
| Enumeration Date | 2022-08-04 | 
| Last Update Date | 2025-08-14 |