| NPI | 1740696632 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: MN 168) |
| Additional Taxonomies | 174N00000X Lactation Consultant, Non-RN (Licence: L-57084) |
| Enumeration Date | 2014-07-11 |
| Last Update Date | 2023-07-14 |