| NPI | 1235207796 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: TN 15707) |
| Additional Taxonomies | 363LP0200X Nurse Practitioner, Pediatrics (Licence: TX 7350410) |
| 163WG0000X Registered Nurse, General Practice (Licence: TN 151921) | |
| Enumeration Date | 2006-12-01 |
| Last Update Date | 2011-03-30 |