| NPI | 1326076662 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: MN 1347) |
| Additional Taxonomies | 363LP0200X Nurse Practitioner, Pediatrics (Licence: MN R1030587) |
| Enumeration Date | 2006-06-28 |
| Last Update Date | 2020-10-08 |