| NPI | 1184051815 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: MN R157910-3) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: MN 1579103) |
| Enumeration Date | 2013-09-26 |
| Last Update Date | 2018-07-16 |