| NPI | 1477758696 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: MN 20111983) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: MN R 165945-0) |
| Enumeration Date | 2007-06-18 |
| Last Update Date | 2024-09-12 |