| NPI | 1245788652 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0200X Nurse Practitioner Pediatrics (Licence: MN CNP 4713) |
| Additional Taxonomies | 364SP0200X Clinical Nurse Specialist Pediatrics (Licence: IA C145251) |
| Enumeration Date | 2016-09-14 |
| Last Update Date | 2018-03-17 |