| NPI | 1811291552 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: TX 645188) |
| Additional Taxonomies | 363LP0200X Nurse Practitioner, Pediatrics (Licence: IN 28044606A) |
| Enumeration Date | 2011-01-10 |
| Last Update Date | 2011-01-10 |