NPI | 1558878363 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: MN 5689) |
Additional Taxonomies | 163W00000X Registered Nurse (Licence: MN 1786022) |
Enumeration Date | 2018-01-02 |
Last Update Date | 2019-11-21 |