| NPI | 1396049961 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: TX 637295) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: TX AP113120) |
| Enumeration Date | 2010-12-22 |
| Last Update Date | 2021-10-15 |