| NPI | 1780067033 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LG0600X Nurse Practitioner, Gerontology (Licence: MN CNP 3969) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: MN R-203335-0) |
| Enumeration Date | 2015-07-06 |
| Last Update Date | 2015-07-07 |