NPI | 1376747261 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LG0600X Nurse Practitioner, Gerontology (Licence: WI 2004-33) |
Additional Taxonomies | 363LG0600X Nurse Practitioner, Gerontology (Licence: MN R200410-1) |
Enumeration Date | 2007-06-13 |
Last Update Date | 2019-08-14 |