| NPI | 1003137993 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: MN 20130931) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: MN R 167747-4) |
| Enumeration Date | 2010-06-15 |
| Last Update Date | 2015-04-09 |