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 |