| 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 |