| NPI | 1073863882 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: TX AP139775) |
| Additional Taxonomies | 363LP0200X Nurse Practitioner, Pediatrics (Licence: AR A03056 ANP) |
| 363LP2300X Nurse Practitioner, Primary Care (Licence: AR A003056) | |
| Enumeration Date | 2012-09-19 |
| Last Update Date | 2023-02-03 |