| NPI | 1417162025 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: TX 687897) | 
| Additional Taxonomies | 363LP0200X Nurse Practitioner, Pediatrics (Licence: TX AP114958) | 
| Enumeration Date | 2007-05-14 | 
| Last Update Date | 2023-02-06 |