| NPI | 1366191066 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MN 9086) |
| Additional Taxonomies | 363LA2200X Nurse Practitioner Adult Health (Licence: MN 9086) |
| 363LG0600X Nurse Practitioner Gerontology (Licence: MN 9086) | |
| Enumeration Date | 2022-03-21 |
| Last Update Date | 2022-03-21 |