NPI | 1720753387 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: TX 1033365) |
Additional Taxonomies | 208000000X Pediatrics (Licence: TX 1033365) |
Enumeration Date | 2021-08-14 |
Last Update Date | 2025-07-01 |