| NPI | 1720977408 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: UT 9521666-4405) |
| Additional Taxonomies | 363LP0200X Nurse Practitioner, Pediatrics (Licence: UT 95216664405) |
| Enumeration Date | 2025-06-30 |
| Last Update Date | 2026-01-13 |