| NPI | 1851669113 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MN 363L00000X) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: MN cnp1068) |
| 363LG0600X Nurse Practitioner, Gerontology (Licence: MN 1068) | |
| Enumeration Date | 2011-12-01 |
| Last Update Date | 2024-01-10 |