| NPI | 1912608159 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0200X Nurse Practitioner Pediatrics (Licence: UT 13284667-4405) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: UT 13284667-4405) |
| Enumeration Date | 2023-03-14 |
| Last Update Date | 2023-12-03 |