| NPI | 1578949202 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: TX AP132564) |
| Additional Taxonomies | 363LP0200X Nurse Practitioner, Pediatrics (Licence: NY F382542-1) |
| 363LP0200X Nurse Practitioner, Pediatrics (Licence: NM 83179) | |
| 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: NY F407046) | |
| Enumeration Date | 2015-08-04 |
| Last Update Date | 2025-06-10 |