| NPI | 1609319664 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0200X Nurse Practitioner Pediatrics (Licence: TX AP137950) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: MI 4704268108) |
| Enumeration Date | 2016-11-23 |
| Last Update Date | 2024-05-21 |