NPI | 1093021404 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: TX 685767) |
Additional Taxonomies | 363LP2300X Nurse Practitioner, Primary Care (Licence: TX 685767) |
Enumeration Date | 2010-08-23 |
Last Update Date | 2012-08-16 |