| NPI | 1902203870 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: TX AP126788) |
| Additional Taxonomies | 364SP0200X Clinical Nurse Specialist Pediatrics (Licence: TX AP126788) |
| Enumeration Date | 2014-11-20 |
| Last Update Date | 2022-08-16 |