| NPI | 1861754624 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LG0600X Nurse Practitioner, Gerontology (Licence: MN CNP1232) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: MN R1650365) |
| Enumeration Date | 2012-06-07 |
| Last Update Date | 2024-10-31 |