| NPI | 1760915961 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LG0600X Nurse Practitioner, Gerontology (Licence: MN 5055) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: MN AG02170152) |
| Enumeration Date | 2017-04-05 |
| Last Update Date | 2022-05-24 |