| NPI | 1417205451 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: WI 130332) |
| Additional Taxonomies | 363LG0600X Nurse Practitioner, Gerontology (Licence: MN R 203239-3) |
| 363LG0600X Nurse Practitioner, Gerontology (Licence: WI F0612968) | |
| Enumeration Date | 2012-08-23 |
| Last Update Date | 2020-09-15 |