| NPI | 1790940633 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 364SP0200X Clinical Nurse Specialist, Pediatrics (Licence: TX 517550)  | 
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: TX 517550)  | 
| Enumeration Date | 2008-07-21 | 
| Last Update Date | 2012-03-09 |