| NPI | 1619402468 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: TX AP133310) |
| Additional Taxonomies | 363LP0200X Nurse Practitioner, Pediatrics (Licence: MT NUR-APRN-LIC-105537) |
| Enumeration Date | 2017-04-28 |
| Last Update Date | 2021-06-25 |