| NPI | 1609290717 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 363LG0600X Nurse Practitioner, Gerontology (Licence: MN 660) | 
| Additional Taxonomies | 363LP2300X Nurse Practitioner, Primary Care (Licence: MN 0660) | 
| Enumeration Date | 2014-02-10 | 
| Last Update Date | 2021-08-05 |