| NPI | 1699799684 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: NM CNP-02627) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: TX 644173) |
| Enumeration Date | 2006-07-26 |
| Last Update Date | 2019-05-22 |