| NPI | 1821550591 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MN 6523) |
| Additional Taxonomies | 363LG0600X Nurse Practitioner, Gerontology (Licence: MN 6523) |
| Enumeration Date | 2019-04-02 |
| Last Update Date | 2023-03-21 |