| NPI | 1336562172 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LG0600X Nurse Practitioner, Gerontology (Licence: MN 5629) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: WI 5655) |
| 363LA2200X Nurse Practitioner, Adult Health (Licence: WI 5655) | |
| 363LG0600X Nurse Practitioner, Gerontology (Licence: WI 5655) | |
| Enumeration Date | 2014-01-30 |
| Last Update Date | 2024-07-19 |