| NPI | 1053558247 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MN CP2135) |
| Additional Taxonomies | 363LP0200X Nurse Practitioner Pediatrics (Licence: MN R 153697-1) |
| Enumeration Date | 2009-01-09 |
| Last Update Date | 2018-12-19 |