| NPI | 1609205707 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LG0600X Nurse Practitioner, Gerontology (Licence: MN 10934) |
| Additional Taxonomies | 163WA0400X Registered Nurse, Addiction (Substance Use Disorder) (Licence: MN R 203829-0) |
| Enumeration Date | 2013-11-08 |
| Last Update Date | 2024-02-08 |