| NPI | 1043388192 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 163W00000X Registered Nurse (Licence: MN R0634023) |
| Additional Taxonomies | 363LP0200X Nurse Practitioner, Pediatrics (Licence: MN 82001) |
| Enumeration Date | 2006-11-30 |
| Last Update Date | 2007-07-08 |