| NPI | 1861747024 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: TX 658583) |
| Additional Taxonomies | 363LP0200X Nurse Practitioner, Pediatrics (Licence: TX AP122031) |
| Enumeration Date | 2012-07-13 |
| Last Update Date | 2024-01-15 |