| NPI | 1932145158 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MN R 083633-9) |
| Additional Taxonomies | 363LP0200X Nurse Practitioner, Pediatrics (Licence: MN R 083633-9) |
| Enumeration Date | 2006-06-22 |
| Last Update Date | 2007-12-12 |