| NPI | 1215292909 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: AK 1413) |
| Additional Taxonomies | 363LP0200X Nurse Practitioner, Pediatrics (Licence: MN R1792951) |
| Enumeration Date | 2012-07-09 |
| Last Update Date | 2016-02-08 |