| NPI | 1548222706 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | |
| Primary Taxonomy | 363LP0200X Nurse Practitioner Pediatrics (Licence: UT 335696-8900) |
| Additional Taxonomies | 363LP0200X Nurse Practitioner Pediatrics (Licence: UT 335696-4405) |
| Enumeration Date | 2006-04-04 |
| Last Update Date | 2007-07-08 |