| NPI | 1083969778 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MN 1781) |
| Additional Taxonomies | 363LA2200X Nurse Practitioner, Adult Health (Licence: MN A0712012) |
| 363LG0600X Nurse Practitioner, Gerontology (Licence: MN G0712002) | |
| Enumeration Date | 2012-07-18 |
| Last Update Date | 2022-09-28 |