| NPI | 1467007096 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: MN 9849) |
| Additional Taxonomies | 363LP0200X Nurse Practitioner, Pediatrics (Licence: IA C155598) |
| Enumeration Date | 2019-08-09 |
| Last Update Date | 2023-01-10 |