| NPI | 1639538424 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: NM CNP-02836) |
| Additional Taxonomies | 363LP0200X Nurse Practitioner, Pediatrics (Licence: TX AP129834) |
| Enumeration Date | 2016-02-22 |
| Last Update Date | 2018-04-23 |