| NPI | 1538396569 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: TX 789061) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: LA 115449) |
| Enumeration Date | 2009-06-17 |
| Last Update Date | 2015-09-04 |