NPI | 1922369115 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LG0600X Nurse Practitioner, Gerontology (Licence: MN R192604-4) |
Additional Taxonomies | 363LP2300X Nurse Practitioner, Primary Care (Licence: ND R32006) |
Enumeration Date | 2012-06-04 |
Last Update Date | 2021-03-17 |