| NPI | 1568805943 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: MN R183613-4) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: MN R183613-4) |
| 363LG0600X Nurse Practitioner, Gerontology (Licence: MN R183613-4) | |
| Enumeration Date | 2013-04-16 |
| Last Update Date | 2016-05-19 |