| NPI | 1902109879 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: AK 116349) |
| Additional Taxonomies | 363LP0200X Nurse Practitioner, Pediatrics (Licence: TX 605415) |
| 363L00000X Nurse Practitioner (Licence: TX 605415) | |
| Enumeration Date | 2010-12-14 |
| Last Update Date | 2017-02-21 |