| NPI | 1629088976 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LG0600X Nurse Practitioner, Gerontology (Licence: MN R 173905-3) |
| Additional Taxonomies | 363LG0600X Nurse Practitioner, Gerontology (Licence: CO 95857) |
| Enumeration Date | 2006-08-09 |
| Last Update Date | 2007-07-08 |