| NPI | 1356017255 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LG0600X Nurse Practitioner, Gerontology (Licence: MN CNP8422) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: MN R2025740) |
| Enumeration Date | 2021-08-19 |
| Last Update Date | 2024-03-08 |