| NPI | 1568982486 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: MN CNP5244) |
| Additional Taxonomies | 163WP0200X Registered Nurse, Pediatrics (Licence: MN 183250-7) |
| Enumeration Date | 2017-06-21 |
| Last Update Date | 2017-10-06 |