| NPI | 1114287422 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: TX AP116809) |
| Additional Taxonomies | 163WP0200X Registered Nurse, Pediatrics (Licence: TX 717639) |
| Enumeration Date | 2012-05-21 |
| Last Update Date | 2015-11-17 |