| NPI | 1629021647 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: UT 216392-4405) |
| Additional Taxonomies | 363LP0200X Nurse Practitioner, Pediatrics (Licence: UT 21632-4405) |
| Enumeration Date | 2006-05-19 |
| Last Update Date | 2021-12-16 |