| NPI | 1386067833 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: MN 6001) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: MN 218269-6) |
| Enumeration Date | 2014-02-03 |
| Last Update Date | 2018-08-30 |