| NPI | 1013995257 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0200X Nurse Practitioner Pediatrics (Licence: MN CNP1167) |
| Additional Taxonomies | 363LP0200X Nurse Practitioner Pediatrics (Licence: ND R21613) |
| 363LP0200X Nurse Practitioner Pediatrics (Licence: MN R113223-6) | |
| Enumeration Date | 2006-01-06 |
| Last Update Date | 2019-05-08 |