| NPI | 1376092510 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: LA AP08926) |
| Additional Taxonomies | 363LP0200X Nurse Practitioner, Pediatrics (Licence: TX AP132093) |
| Enumeration Date | 2016-09-29 |
| Last Update Date | 2018-05-02 |