| NPI | 1225576101 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0200X Nurse Practitioner Pediatrics (Licence: MN CNP 5006) |
| Additional Taxonomies | 363LP0808X Nurse Practitioner Psychiatric/Mental Health (Licence: MN 5006) |
| Enumeration Date | 2017-02-10 |
| Last Update Date | 2021-01-08 |