| NPI | 1083027536 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: MN 1609303) |
| Additional Taxonomies | 363LA2200X Nurse Practitioner, Adult Health (Licence: MN 190) |
| 363LG0600X Nurse Practitioner, Gerontology (Licence: MN R160930-3) | |
| Enumeration Date | 2014-06-03 |
| Last Update Date | 2023-12-22 |