| NPI | 1790835445 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LG0600X Nurse Practitioner, Gerontology (Licence: MN R1088908) |
| Additional Taxonomies | 163WC1500X Registered Nurse, Community Health (Licence: WI 115271-030) |
| 363LG0600X Nurse Practitioner, Gerontology (Licence: WI 4024-033) | |
| Enumeration Date | 2007-01-12 |
| Last Update Date | 2021-03-11 |