| NPI | 1104227289 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LN0000X Nurse Practitioner, Neonatal (Licence: MN 5087) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: OH COA.16474-NP) |
| 363L00000X Nurse Practitioner (Licence: MN CNP5087) | |
| Enumeration Date | 2014-09-09 |
| Last Update Date | 2022-06-22 |