| NPI | 1659699221 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 171000000X Military Health Care Provider (Licence: TX 730972) |
| Additional Taxonomies | 363LP0200X Nurse Practitioner, Pediatrics (Licence: TX 730972) |
| Enumeration Date | 2010-05-06 |
| Last Update Date | 2025-03-07 |