| NPI | 1609636083 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: TX 1155402) |
| Additional Taxonomies | 163WG0000X Registered Nurse, General Practice (Licence: MO 2023045205) |
| Enumeration Date | 2024-03-21 |
| Last Update Date | 2024-09-13 |