| NPI | 1154380871 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LG0600X Nurse Practitioner, Gerontology (Licence: MN CNP 2753) |
| Additional Taxonomies | 363LG0600X Nurse Practitioner, Gerontology (Licence: MN R 94784-6) |
| Enumeration Date | 2006-03-21 |
| Last Update Date | 2020-01-08 |