| NPI | 1659771822 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0200X Nurse Practitioner Pediatrics (Licence: TX 744205) |
| Additional Taxonomies | 363LP0200X Nurse Practitioner Pediatrics (Licence: TX AP123829) |
| Enumeration Date | 2014-08-25 |
| Last Update Date | 2015-08-07 |