| NPI | 1679239818 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: TX 1030365) |
| Additional Taxonomies | 207Y00000X Otolaryngology (Licence: TX 1030365) |
| Enumeration Date | 2021-11-11 |
| Last Update Date | 2022-02-23 |