| NPI | 1164456703 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: TX AP132123) |
| Additional Taxonomies | 363LP0200X Nurse Practitioner, Pediatrics (Licence: OH RN.156480-COA1) |
| Enumeration Date | 2006-07-10 |
| Last Update Date | 2020-11-03 |