| NPI | 1962625921 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: TX 681462) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: NC 0050-00974) |
| Enumeration Date | 2007-04-10 |
| Last Update Date | 2019-07-10 |