| NPI | 1790981470 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: TX 630600) |
| Additional Taxonomies | 363LP0200X Nurse Practitioner, Pediatrics (Licence: GA 190298) |
| Enumeration Date | 2007-06-21 |
| Last Update Date | 2019-07-25 |