| NPI | 1003350695 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LG0600X Nurse Practitioner, Gerontology (Licence: IL 209-019949) |
| Additional Taxonomies | 363LA2200X Nurse Practitioner, Adult Health (Licence: IL 209-019949) |
| 363LA2200X Nurse Practitioner, Adult Health (Licence: MN CNP4757) | |
| 363LG0600X Nurse Practitioner, Gerontology (Licence: MN CNP4757) | |
| Enumeration Date | 2016-12-15 |
| Last Update Date | 2022-09-27 |