| NPI | 1649676198 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: TX AP126840) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: TX 734084) |
| Enumeration Date | 2014-11-11 |
| Last Update Date | 2017-11-28 |