NPI | 1164813416 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: TX 712565) |
Additional Taxonomies | 363LP2300X Nurse Practitioner, Primary Care (Licence: TX AP126904) |
363LP0200X Nurse Practitioner, Pediatrics (Licence: TX AP126904) | |
Enumeration Date | 2015-02-09 |
Last Update Date | 2024-05-14 |