| NPI | 1609252410 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LG0600X Nurse Practitioner Gerontology (Licence: MN CNP 4046) |
| Additional Taxonomies | 363LA2200X Nurse Practitioner Adult Health (Licence: MN CNP 4046) |
| Enumeration Date | 2015-08-04 |
| Last Update Date | 2022-05-10 |