| NPI | 1174035778 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LATIA HICKERSON Owner 832-930-6345 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LW0102X Nurse Practitioner, Women's Health |
| Additional Taxonomies | 163WL0100X Registered Nurse, Lactation Consultant |
| Enumeration Date | 2017-11-04 |
| Last Update Date | 2018-06-06 |