| NPI | 1104954015 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: TX AP112442) |
| Additional Taxonomies | 363LP0200X Nurse Practitioner Pediatrics (Licence: TX 605032) |
| Enumeration Date | 2007-03-01 |
| Last Update Date | 2019-05-13 |