| NPI | 1205068830 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0200X Nurse Practitioner Pediatrics (Licence: DC PENDING) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: TX 773414) |
| 363LP0200X Nurse Practitioner Pediatrics (Licence: TX 773414) | |
| Enumeration Date | 2009-08-15 |
| Last Update Date | 2022-06-20 |