| NPI | 1740940683 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0200X Nurse Practitioner Pediatrics (Licence: TX 1061911) |
| Additional Taxonomies | 363LP2300X Nurse Practitioner Primary Care (Licence: TX 1061911) |
| Enumeration Date | 2021-12-20 |
| Last Update Date | 2022-12-05 |