NPI | 1003262734 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LG0600X Nurse Practitioner, Gerontology (Licence: MN R 122631 7) |
Additional Taxonomies | 363LA2200X Nurse Practitioner, Adult Health (Licence: MN R 122631 7) |
Enumeration Date | 2016-05-12 |
Last Update Date | 2016-05-12 |