| NPI | 1962431171 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: MN R 089101-5) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: MN R 089101-5) |
| Enumeration Date | 2006-07-01 |
| Last Update Date | 2025-09-28 |