| NPI | 1649676487 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: MN AG1014104) |
| Additional Taxonomies | 363LG0600X Nurse Practitioner, Gerontology (Licence: MN AG1014104) |
| Enumeration Date | 2014-11-05 |
| Last Update Date | 2019-03-18 |