| NPI | 1760575179 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: TX AP125780) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: OH NP08195, RN304751) |
| Enumeration Date | 2006-09-30 |
| Last Update Date | 2021-06-15 |