| NPI | 1144530387 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LG0600X Nurse Practitioner, Gerontology (Licence: MN 1483600) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: MN CNP 1493) |
| 363LA2200X Nurse Practitioner, Adult Health (Licence: MN CNP 1493) | |
| Enumeration Date | 2010-10-20 |
| Last Update Date | 2023-09-11 |