| NPI | 1548562960 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: TX 103190) |
| Additional Taxonomies | 163WP0200X Registered Nurse, Pediatrics (Licence: NY 605550) |
| Enumeration Date | 2010-11-18 |
| Last Update Date | 2024-08-08 |