| NPI | 1699929323 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: MN R157859-9) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: MN R 157859-9) |
| Enumeration Date | 2008-11-07 |
| Last Update Date | 2013-01-17 |