NPI | 1780040634 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MN 4343) |
Additional Taxonomies | 363LP0200X Nurse Practitioner, Pediatrics (Licence: MN 4343) |
Enumeration Date | 2016-01-07 |
Last Update Date | 2020-08-10 |