| NPI | 1467032250 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LG0600X Nurse Practitioner, Gerontology (Licence: MN 8053) |
| Additional Taxonomies | 363LA2200X Nurse Practitioner, Adult Health (Licence: NY 310324) |
| Enumeration Date | 2021-04-14 |
| Last Update Date | 2021-10-30 |