| NPI | 1134121650 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0200X Nurse Practitioner Pediatrics (Licence: TX AP112639) |
| Additional Taxonomies | 174400000X Specialist (Licence: TX 675197) |
| Enumeration Date | 2005-08-15 |
| Last Update Date | 2023-12-11 |