| NPI | 1760095251 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP2300X Nurse Practitioner Primary Care (Licence: TX 1009393) |
| Additional Taxonomies | 363LP0200X Nurse Practitioner Pediatrics (Licence: TX 1009393) |
| Enumeration Date | 2020-08-25 |
| Last Update Date | 2021-11-05 |