NPI | 1780065862 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LG0600X Nurse Practitioner, Gerontology (Licence: MN 12112) |
Additional Taxonomies | 163W00000X Registered Nurse (Licence: MN R2095660) |
Enumeration Date | 2015-06-15 |
Last Update Date | 2025-03-04 |