| NPI | 1164563813 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: TX 685365) |
| Additional Taxonomies | 363LN0000X Nurse Practitioner, Neonatal (Licence: TX 685965) |
| 363LP2300X Nurse Practitioner, Primary Care (Licence: TX 685965) | |
| Enumeration Date | 2007-02-08 |
| Last Update Date | 2010-07-15 |