| NPI | 1508898677 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LG0600X Nurse Practitioner, Gerontology (Licence: MN R 95529-4) |
| Additional Taxonomies | 363LG0600X Nurse Practitioner, Gerontology (Licence: WI 81970-030) |
| 363L00000X Nurse Practitioner (Licence: MN R 95529-4) | |
| Enumeration Date | 2006-07-07 |
| Last Update Date | 2013-11-15 |