| NPI | 1750658472 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: TX 94174) |
| Additional Taxonomies | 163WP0200X Registered Nurse, Pediatrics (Licence: TX 565305) |
| Enumeration Date | 2011-11-23 |
| Last Update Date | 2012-10-16 |