| NPI | 1902309511 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: NC 5021251) |
| Additional Taxonomies | 363LP0200X Nurse Practitioner, Pediatrics (Licence: TX AP136962) |
| Enumeration Date | 2018-03-10 |
| Last Update Date | 2025-01-14 |