| NPI | 1770573842 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: TX AP104242) |
| Additional Taxonomies | 363LP0200X Nurse Practitioner, Pediatrics (Licence: TX 579874) |
| Enumeration Date | 2005-10-28 |
| Last Update Date | 2019-11-26 |