| NPI | 1770765133 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MN R1869774) |
| Additional Taxonomies | 363LN0005X Nurse Practitioner, Neonatal, Critical Care (Licence: NE 110921) |
| Enumeration Date | 2007-11-28 |
| Last Update Date | 2012-11-27 |