| NPI | 1639525496 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0200X Nurse Practitioner Pediatrics (Licence: TX 1121634) |
| Additional Taxonomies | 363LP0200X Nurse Practitioner Pediatrics (Licence: TN 20428) |
| Enumeration Date | 2016-05-11 |
| Last Update Date | 2023-06-12 |