| NPI | 1982111431 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: TX 1058595) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: CA 95007383) |
| 208000000X Pediatrics (Licence: TX 1058595) | |
| 363LP0200X Nurse Practitioner, Pediatrics (Licence: CA 95007383) | |
| Enumeration Date | 2018-01-05 |
| Last Update Date | 2023-02-23 |