| NPI | 1912565474 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0222X Nurse Practitioner, Pediatrics, Critical Care (Licence: KY 3016418) |
| Additional Taxonomies | 363LP0200X Nurse Practitioner, Pediatrics (Licence: TX AP139810) |
| 363LP0200X Nurse Practitioner, Pediatrics (Licence: KY 3016418) | |
| Enumeration Date | 2019-05-30 |
| Last Update Date | 2022-08-30 |