| NPI | 1053774984 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: TX AP130787) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: TX 184489) |
| Enumeration Date | 2016-03-29 |
| Last Update Date | 2020-11-16 |