| NPI | 1750061917 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: TX 1151214) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: OH APRN.CNP.0028452) |
| Enumeration Date | 2023-07-24 |
| Last Update Date | 2024-07-24 |