| NPI | 1780987644 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: TX AP119393) |
| Additional Taxonomies | 363LP0200X Nurse Practitioner, Pediatrics (Licence: TX 717132) |
| Enumeration Date | 2010-12-15 |
| Last Update Date | 2019-11-12 |