NPI | 1013109610 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LG0600X Nurse Practitioner, Gerontology (Licence: MN 3059) |
Additional Taxonomies | 363LA2200X Nurse Practitioner, Adult Health (Licence: MN R1403130) |
Enumeration Date | 2007-08-16 |
Last Update Date | 2022-08-23 |