| NPI | 1265778633 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: MN 0229) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: MN 210263-4) |
| Enumeration Date | 2012-12-12 |
| Last Update Date | 2024-01-24 |