| NPI | 1871091876 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: NM CNP03554) |
| Additional Taxonomies | 363LP0200X Nurse Practitioner, Pediatrics (Licence: TX AP135944) |
| 363LP0200X Nurse Practitioner, Pediatrics (Licence: NM CNP-03554) | |
| Enumeration Date | 2018-01-25 |
| Last Update Date | 2021-12-13 |