| NPI | 1922516780 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208000000X Pediatrics (Licence: MN 9702) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: MN R148166-0) |
| 363LP0200X Nurse Practitioner, Pediatrics (Licence: MN 9702) | |
| Enumeration Date | 2018-01-15 |
| Last Update Date | 2023-01-05 |