| NPI | 1629495346 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: MN AG0314012) |
| Additional Taxonomies | 363LG0600X Nurse Practitioner, Gerontology (Licence: MN AG0314012) |
| Enumeration Date | 2014-03-19 |
| Last Update Date | 2021-03-11 |