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 |