| NPI | 1699253468 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LG0600X Nurse Practitioner, Gerontology (Licence: MN 6070) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: MN 1991914) |
| 363LA2200X Nurse Practitioner, Adult Health (Licence: MN 6070) | |
| Enumeration Date | 2018-08-02 |
| Last Update Date | 2018-11-25 |