| NPI | 1790456531 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: TX 1047216) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: TX 1047216) |
| Enumeration Date | 2021-09-22 |
| Last Update Date | 2022-10-03 |