| NPI | 1427220912 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: VA 0024174898) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: TX 600557) |
| 363LP0200X Nurse Practitioner Pediatrics (Licence: VA 0024174898) | |
| Enumeration Date | 2008-03-25 |
| Last Update Date | 2022-10-11 |