| NPI | 1073879839 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: TX AP144115) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: OR 201404725NP-PP) |
| Enumeration Date | 2012-04-05 |
| Last Update Date | 2022-04-28 |