| NPI | 1548872963 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MN 11338) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: OR 201902527RN) |
| 363LP0200X Nurse Practitioner, Pediatrics (Licence: MN 2377252) | |
| Enumeration Date | 2020-08-18 |
| Last Update Date | 2024-09-10 |