| NPI | 1710305271 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MN 3056) |
| Additional Taxonomies | 363LP0200X Nurse Practitioner, Pediatrics (Licence: MN R-137276-6) |
| Enumeration Date | 2014-04-02 |
| Last Update Date | 2024-02-23 |