| NPI | 1316495575 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: MN 4061) |
| Additional Taxonomies | 363LP0200X Nurse Practitioner, Pediatrics (Licence: WA 60688454) |
| Enumeration Date | 2016-09-16 |
| Last Update Date | 2019-11-21 |