| NPI | 1124142849 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: MN 19990640) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: MN R 128860-1) |
| 363LP0200X Nurse Practitioner, Pediatrics (Licence: MN R 128860-1) | |
| Enumeration Date | 2007-03-19 |
| Last Update Date | 2025-09-11 |