| NPI | 1053580563 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LG0600X Nurse Practitioner, Gerontology (Licence: MN 2060) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: MN R1248489) |
| Enumeration Date | 2008-02-28 |
| Last Update Date | 2024-05-21 |