| NPI | 1265779029 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: TX 2247) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: NC 182941) |
| Enumeration Date | 2013-01-12 |
| Last Update Date | 2013-01-12 |