| NPI | 1790808681 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: MO 061036) |
| Additional Taxonomies | 363LP0200X Nurse Practitioner, Pediatrics (Licence: TX AP133887) |
| Enumeration Date | 2007-04-07 |
| Last Update Date | 2022-09-22 |