| NPI | 1659962124 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: MN 11946) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: MN 2470781) |
| Enumeration Date | 2021-01-28 |
| Last Update Date | 2024-08-15 |