| NPI | 1801557145 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LG0600X Nurse Practitioner, Gerontology (Licence: MN 8504) |
| Additional Taxonomies | 246YC3302X Spec/Tech, Health Info, Coding Specialist, Physician Office Based |
| Enumeration Date | 2022-01-08 |
| Last Update Date | 2024-07-10 |