| NPI | 1407847551 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: MN R095701-4) |
| Additional Taxonomies | 363LP0200X Nurse Practitioner, Pediatrics (Licence: MN R-095701-4) |
| Enumeration Date | 2005-10-28 |
| Last Update Date | 2011-12-08 |