| NPI | 1194014779 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: MN CNP1060) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: MN R 200209-3) |
| Enumeration Date | 2011-04-04 |
| Last Update Date | 2024-03-06 |