| NPI | 1003201138 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: ID 74206) |
| Additional Taxonomies | 363LP0200X Nurse Practitioner, Pediatrics (Licence: MN CNP3754) |
| Enumeration Date | 2015-04-06 |
| Last Update Date | 2023-02-10 |