| NPI | 1396139044 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: WI 7416) |
| Additional Taxonomies | 363LA2200X Nurse Practitioner, Adult Health (Licence: MN CNP 3715) |
| 363LG0600X Nurse Practitioner, Gerontology (Licence: MN CNP 3715) | |
| Enumeration Date | 2015-03-20 |
| Last Update Date | 2020-09-11 |