| NPI | 1043779465 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: TX AP140910) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: TX AP140910) |
| Enumeration Date | 2019-03-15 |
| Last Update Date | 2020-12-08 |