| NPI | 1225004377 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: MN R073501-6) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: MN 0735016) |
| Enumeration Date | 2006-02-28 |
| Last Update Date | 2011-09-07 |