| 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 |