NPI | 1972128510 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: TX 1033816) |
Additional Taxonomies | 363LP0200X Nurse Practitioner, Pediatrics (Licence: MO 2019042361) |
Enumeration Date | 2020-06-09 |
Last Update Date | 2025-05-21 |