| NPI | 1720345705 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: MN 556) |
| Additional Taxonomies | 363LP0200X Nurse Practitioner, Pediatrics (Licence: MN R203760-2) |
| Enumeration Date | 2012-04-16 |
| Last Update Date | 2013-05-24 |