| NPI | 1164426714 |
|---|---|
| Former Name | MARJORIE LOUISE SEIDL |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | |
| Primary Taxonomy | 363LP0200X Nurse Practitioner Pediatrics (Licence: MN 88001) |
| Additional Taxonomies | 364SP0200X Clinical Nurse Specialist Pediatrics (Licence: MN R0510891) |
| Enumeration Date | 2005-06-10 |
| Last Update Date | 2007-07-08 |