| 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 |