| NPI | 1629500988 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: MN CNP5615) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: MN R-2460819) |
| Enumeration Date | 2017-03-28 |
| Last Update Date | 2024-09-11 |