| NPI | 1043452972 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: TX 162093) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: LA AP05388) |
| Enumeration Date | 2009-03-24 |
| Last Update Date | 2014-04-16 |