| NPI | 1518944230 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: MN CNP 0757)  | 
| Additional Taxonomies | 163WP0200X Registered Nurse, Pediatrics (Licence: MN R111719-6)  | 
| Enumeration Date | 2005-12-22 | 
| Last Update Date | 2016-03-04 |