| NPI | 1366727083 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: TX AP120975) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: TX 730516) |
| Enumeration Date | 2011-10-13 |
| Last Update Date | 2021-04-26 |