| NPI | 1265612774 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: MN 1153) |
| Additional Taxonomies | 363LP0200X Nurse Practitioner, Pediatrics (Licence: MN 20071427) |
| 363LP0222X Nurse Practitioner, Pediatrics, Critical Care (Licence: MN 20071427) | |
| Enumeration Date | 2007-11-13 |
| Last Update Date | 2022-05-10 |