| NPI | 1811963382 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MN 0954) | 
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: MN R1415076) | 
| 363LG0600X Nurse Practitioner, Gerontology (Licence: MN R141507-6) | |
| Enumeration Date | 2006-02-24 | 
| Last Update Date | 2024-05-17 |