| NPI | 1154519056 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: TX AP130474) | 
| Additional Taxonomies | 163WP0200X Registered Nurse, Pediatrics (Licence: FL ARNP2573592) | 
| 363L00000X Nurse Practitioner (Licence: FL ARNP2573592) | |
| Enumeration Date | 2007-10-05 | 
| Last Update Date | 2016-04-24 |