| NPI | 1255742656 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: TX AP125574) |
| Additional Taxonomies | 363LP0200X Nurse Practitioner, Pediatrics (Licence: LA AP07747) |
| Enumeration Date | 2014-05-19 |
| Last Update Date | 2015-04-29 |