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 |