| NPI | 1609434232 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LG0600X Nurse Practitioner, Gerontology (Licence: MN 10711) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: MN RN1806928-2037590) |
| Enumeration Date | 2019-05-29 |
| Last Update Date | 2025-01-06 |