| NPI | 1902749302 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: UT 11129491-4405) |
| Additional Taxonomies | 163WP0200X Registered Nurse, Pediatrics (Licence: UT 11129491-3102) |
| Enumeration Date | 2026-04-10 |
| Last Update Date | 2026-07-20 |