| NPI | 1063088094 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: MN 2468654) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: MN 2468654) |
| 363LG0600X Nurse Practitioner, Gerontology (Licence: MN 9890) | |
| Enumeration Date | 2021-06-01 |
| Last Update Date | 2023-08-02 |