| NPI | 1972249878 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: MN 9428) |
| Additional Taxonomies | 163WP0200X Registered Nurse, Pediatrics (Licence: MN 2476094) |
| Enumeration Date | 2022-05-12 |
| Last Update Date | 2022-08-19 |