| NPI | 1750854410 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LG0600X Nurse Practitioner, Gerontology (Licence: MN 11247) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: IA A116715) |
| Enumeration Date | 2019-01-05 |
| Last Update Date | 2025-08-13 |