| NPI | 1568181782 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: TX 1007004) |
| Additional Taxonomies | 208100000X Physical Medicine & Rehabilitation (Licence: TX 1007004) |
| Enumeration Date | 2022-08-22 |
| Last Update Date | 2022-09-21 |