| NPI | 1861126443 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP2300X Nurse Practitioner, Primary Care (Licence: TX 1088303) |
| Additional Taxonomies | 363LP0200X Nurse Practitioner, Pediatrics (Licence: TX TEMPMS) |
| Enumeration Date | 2022-07-11 |
| Last Update Date | 2022-09-26 |