| NPI | 1821421181 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: TX AP124930) |
| Additional Taxonomies | 363LP0200X Nurse Practitioner, Pediatrics (Licence: MO 2013027649) |
| 363LP0200X Nurse Practitioner, Pediatrics (Licence: KS 76002) | |
| Enumeration Date | 2013-08-09 |
| Last Update Date | 2019-04-12 |