| NPI | 1700215001 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LG0600X Nurse Practitioner, Gerontology (Licence: MN R-172391-7) |
| Additional Taxonomies | 363LG0600X Nurse Practitioner, Gerontology (Licence: ND R31542) |
| Enumeration Date | 2013-11-06 |
| Last Update Date | 2013-11-06 |