| NPI | 1003872540 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: MN 10170) |
| Additional Taxonomies | 363LP0200X Nurse Practitioner, Pediatrics (Licence: MO 2002028643) |
| 363LP0200X Nurse Practitioner, Pediatrics (Licence: TX 140607) | |
| Enumeration Date | 2006-04-25 |
| Last Update Date | 2023-09-28 |