| NPI | 1083177299 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner Family (Licence: TX AP142388) |
| Additional Taxonomies | 163WP0200X Registered Nurse Pediatrics (Licence: TX 855019) |
| Enumeration Date | 2019-04-13 |
| Last Update Date | 2019-10-22 |