| NPI | 1508265331 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MN 3298) |
| Additional Taxonomies | 363LG0600X Nurse Practitioner Gerontology (Licence: MN AG0614152) |
| Enumeration Date | 2014-08-18 |
| Last Update Date | 2021-03-10 |