| NPI | 1265562102 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: TX AP106078) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: CO 101901) |
| Enumeration Date | 2007-03-07 |
| Last Update Date | 2016-07-20 |