| NPI | 1790389039 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: TX 1013846) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: TX 1013648) |
| Enumeration Date | 2020-11-27 |
| Last Update Date | 2021-03-26 |