| NPI | 1932587920 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: TX AP128117) |
| Additional Taxonomies | 363LP0200X Nurse Practitioner, Pediatrics (Licence: MA 20143032) |
| Enumeration Date | 2015-05-11 |
| Last Update Date | 2015-05-11 |