NPI | 1659643450 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: UT 6191949-4405) |
Additional Taxonomies | 363LP0200X Nurse Practitioner, Pediatrics (Licence: TX 6191949-3102) |
Enumeration Date | 2012-02-08 |
Last Update Date | 2015-08-10 |