NPI | 1285636712 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MN 6396) |
Additional Taxonomies | 363LG0600X Nurse Practitioner, Gerontology (Licence: NM R54246) |
Enumeration Date | 2005-08-15 |
Last Update Date | 2019-09-12 |