NPI | 1003351602 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LG0600X Nurse Practitioner, Gerontology (Licence: MN 5116) |
Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: MN R-188192-7) |
363L00000X Nurse Practitioner (Licence: MN 5116) | |
Enumeration Date | 2017-01-05 |
Last Update Date | 2024-05-17 |