| NPI | 1861016560 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: MN 8926) |
| Additional Taxonomies | 163WP0200X Registered Nurse, Pediatrics (Licence: MN 2318525) |
| Enumeration Date | 2020-05-29 |
| Last Update Date | 2022-03-02 |