| NPI | 1891571535 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: UT 83822424405) |
| Additional Taxonomies | 363LP0200X Nurse Practitioner Pediatrics (Licence: UT 83822424405) |
| Enumeration Date | 2023-09-07 |
| Last Update Date | 2023-11-27 |