| NPI | 1316536584 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: MN 7750) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: MN 7750) |
| Enumeration Date | 2021-01-13 |
| Last Update Date | 2021-03-03 |