| NPI | 1275846214 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: SD CP001876) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: MN R 152833-2) |
| Enumeration Date | 2010-07-20 |
| Last Update Date | 2022-06-29 |