| NPI | 1164738209 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: TX AP131360) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: CA NP19794) |
| 363LP0200X Nurse Practitioner, Pediatrics (Licence: CA NP19794) | |
| Enumeration Date | 2010-08-26 |
| Last Update Date | 2017-01-16 |