| NPI | 1063300143 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LG0600X Nurse Practitioner, Gerontology (Licence: MN 12978) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: MN 12978) |
| Enumeration Date | 2025-06-26 |
| Last Update Date | 2025-09-19 |