| NPI | 1275010688 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: MN 6085) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: MN 2217529) |
| Enumeration Date | 2018-07-27 |
| Last Update Date | 2018-12-17 |