| NPI | 1366569675 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP2300X Nurse Practitioner Primary Care (Licence: TX 1084843) |
| Additional Taxonomies | 363LP0200X Nurse Practitioner Pediatrics (Licence: CA 567762) |
| 363LP0200X Nurse Practitioner Pediatrics (Licence: TX 1084843) | |
| Enumeration Date | 2007-03-23 |
| Last Update Date | 2024-06-17 |