| NPI | 1801224159 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: TX 1111238) | 
| Additional Taxonomies | 363LP0200X Nurse Practitioner, Pediatrics (Licence: PA SP013255) | 
| Enumeration Date | 2013-10-24 | 
| Last Update Date | 2025-07-01 |