| NPI | 1306199799 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LG0600X Nurse Practitioner, Gerontology (Licence: MN G0812010) |
| Additional Taxonomies | 363LA2200X Nurse Practitioner, Adult Health (Licence: MN A0712171) |
| Enumeration Date | 2012-10-22 |
| Last Update Date | 2013-01-02 |