| NPI | 1407206360 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LG0600X Nurse Practitioner, Gerontology (Licence: MN R091492-1) |
| Additional Taxonomies | 363LP0200X Nurse Practitioner, Pediatrics (Licence: MN R091492-1) |
| Enumeration Date | 2016-06-21 |
| Last Update Date | 2016-06-21 |