| NPI | 1306124821 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MN R95598-0) |
| Additional Taxonomies | 363LN0000X Nurse Practitioner, Neonatal (Licence: MN R95598-0) |
| 363LN0005X Nurse Practitioner, Neonatal, Critical Care (Licence: MN R 95598-0) | |
| Enumeration Date | 2011-08-01 |
| Last Update Date | 2018-03-17 |