| NPI | 1912366907 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0222X Nurse Practitioner, Pediatrics, Critical Care (Licence: MN 169516-8) |
| Additional Taxonomies | 363LP0200X Nurse Practitioner, Pediatrics (Licence: MN 169516-8) |
| 363LP2300X Nurse Practitioner, Primary Care (Licence: MN 169516-8) | |
| Enumeration Date | 2016-02-18 |
| Last Update Date | 2016-02-18 |