| NPI | 1164501631 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: UT 272893-4405) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: UT 272893-4405) |
| Enumeration Date | 2006-11-03 |
| Last Update Date | 2017-11-03 |