NPI | 1508907882 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: MN R108587-5) |
Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: MN R108587-5) |
Enumeration Date | 2007-02-09 |
Last Update Date | 2012-04-20 |