| NPI | 1790075422 |
|---|---|
| Former Name | CHRYSTAL GROOMS |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: TX 739918) |
| Additional Taxonomies | 163WP0200X Registered Nurse, Pediatrics (Licence: TX 739918) |
| Enumeration Date | 2011-04-14 |
| Last Update Date | 2024-02-15 |