| NPI | 1639624927 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: MN CNP 4454) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: MN 4454) |
| 363LG0600X Nurse Practitioner, Gerontology (Licence: MN CNP-4454) | |
| Enumeration Date | 2016-08-17 |
| Last Update Date | 2020-02-03 |