| NPI | 1639848153 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: TX 1054841)  | 
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: TX 990029)  | 
| Enumeration Date | 2021-09-08 | 
| Last Update Date | 2024-09-25 |