| NPI | 1750616256 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: MN 20091488) |
| Additional Taxonomies | 163WP0200X Registered Nurse, Pediatrics (Licence: MN R157587-7) |
| Enumeration Date | 2009-10-16 |
| Last Update Date | 2009-10-16 |