NPI | 1487162798 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: MN 7929) |
Additional Taxonomies | 363LP0200X Nurse Practitioner, Pediatrics (Licence: IL 209018427) |
363LP2300X Nurse Practitioner, Primary Care (Licence: MN 7929) | |
Enumeration Date | 2018-01-21 |
Last Update Date | 2023-07-25 |