| NPI | 1932502630 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0200X Nurse Practitioner Pediatrics (Licence: TX AP126780) |
| Additional Taxonomies | 163WP0200X Registered Nurse Pediatrics (Licence: TX 678017) |
| Enumeration Date | 2014-10-08 |
| Last Update Date | 2014-10-31 |