| NPI | 1578183752 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: TX 1070390) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: MO 2018002466) |
| 163W00000X Registered Nurse (Licence: IL 041484734) | |
| Enumeration Date | 2020-04-17 |
| Last Update Date | 2022-06-24 |