| NPI | 1780829259 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: TX 601596) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: TX 601596) |
| 363LF0000X Nurse Practitioner, Family (Licence: TX 08620) | |
| Enumeration Date | 2008-12-11 |
| Last Update Date | 2018-06-13 |