| NPI | 1588625107 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: IA 121268) |
| Additional Taxonomies | 363LP0200X Nurse Practitioner, Pediatrics (Licence: MN R 089542-2) |
| Enumeration Date | 2006-03-31 |
| Last Update Date | 2009-07-16 |