| NPI | 1023557352 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LG0600X Nurse Practitioner Gerontology (Licence: MN CNP 5012) |
| Additional Taxonomies | 363LA2200X Nurse Practitioner Adult Health (Licence: MN CNP 5012) |
| Enumeration Date | 2017-02-20 |
| Last Update Date | 2020-02-25 |