| NPI | 1972016350 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: TX 1011003) |
| Additional Taxonomies | 363LP0200X Nurse Practitioner, Pediatrics (Licence: FL ARNP9448220) |
| Enumeration Date | 2017-11-08 |
| Last Update Date | 2020-10-19 |