| NPI | 1750895223 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: TX 1175137) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: IL 209.019646) |
| 208000000X Pediatrics (Licence: TN 18584) | |
| Enumeration Date | 2017-11-20 |
| Last Update Date | 2024-12-12 |