| NPI | 1740296995 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: HI 1290) |
| Additional Taxonomies | 363LP0200X Nurse Practitioner, Pediatrics (Licence: TX 648059) |
| Enumeration Date | 2006-07-31 |
| Last Update Date | 2014-10-02 |