| NPI | 1235342015 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LG0600X Nurse Practitioner, Gerontology (Licence: MN R68617-8) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: MN r0686178) |
| Enumeration Date | 2007-05-08 |
| Last Update Date | 2011-03-15 |