| NPI | 1851733919 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0200X Nurse Practitioner Pediatrics (Licence: MN CNP 2525) |
| Additional Taxonomies | 363LP0200X Nurse Practitioner Pediatrics (Licence: MN R220801-7) |
| Enumeration Date | 2013-07-17 |
| Last Update Date | 2017-01-26 |