| NPI | 1649659988 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: MN CNP 3876) |
| Additional Taxonomies | 363LG0600X Nurse Practitioner, Gerontology (Licence: MN CNP 3876) |
| Enumeration Date | 2015-05-19 |
| Last Update Date | 2021-03-11 |