| NPI | 1558808980 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: TX AP132761) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: TX AP132761) |
| 363LP0200X Nurse Practitioner, Pediatrics (Licence: TN AP132761) | |
| Enumeration Date | 2017-01-24 |
| Last Update Date | 2023-06-23 |