NPI | 1760126510 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LG0600X Nurse Practitioner, Gerontology (Licence: MN 9133) |
Additional Taxonomies | 363LA2200X Nurse Practitioner, Adult Health (Licence: MN 9133) |
Enumeration Date | 2022-04-26 |
Last Update Date | 2022-04-26 |