| NPI | 1063795912 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0222X Nurse Practitioner, Pediatrics, Critical Care (Licence: TX 737242) |
| Additional Taxonomies | 163WP0200X Registered Nurse, Pediatrics (Licence: TX 737242) |
| Enumeration Date | 2011-09-27 |
| Last Update Date | 2011-11-03 |