| NPI | 1376851741 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: MN 5806) |
| Additional Taxonomies | 363LP0200X Nurse Practitioner, Pediatrics (Licence: WI 89566-30) |
| Enumeration Date | 2010-09-20 |
| Last Update Date | 2018-05-07 |