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 |