| NPI | 1699341172 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: TX 1036830) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: TX 1036830) |
| 208000000X Pediatrics (Licence: TX AP1036830) | |
| Enumeration Date | 2021-06-03 |
| Last Update Date | 2021-07-08 |