| NPI | 1134783574 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MN 6374) |
| Additional Taxonomies | 363LG0600X Nurse Practitioner, Gerontology (Licence: MN 6374) |
| Enumeration Date | 2019-04-30 |
| Last Update Date | 2020-10-06 |