| NPI | 1003076803 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: TX AP123002) |
| Additional Taxonomies | 363LP0200X Nurse Practitioner, Pediatrics (Licence: NY 382122) |
| 163W00000X Registered Nurse (Licence: TX 683962) | |
| Enumeration Date | 2008-06-15 |
| Last Update Date | 2015-06-23 |