NPI | 1326243148 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: TX 697627) |
Additional Taxonomies | 163W00000X Registered Nurse (Licence: TX 697627) |
Enumeration Date | 2007-06-20 |
Last Update Date | 2014-02-05 |