| NPI | 1881059707 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP2300X Nurse Practitioner, Primary Care (Licence: MN CNP4375) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: MN CNP4375) |
| 363LG0600X Nurse Practitioner, Gerontology (Licence: MN CNP4375) | |
| Enumeration Date | 2015-12-18 |
| Last Update Date | 2025-05-01 |