| NPI | 1780903047 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MN 2824) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: ND 6273) |
| 363L00000X Nurse Practitioner (Licence: MN 1674891) | |
| 363LP0200X Nurse Practitioner, Pediatrics (Licence: MN R 167489-1) | |
| Enumeration Date | 2010-05-26 |
| Last Update Date | 2020-08-07 |