NPI | 1962430694 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LG0600X Nurse Practitioner, Gerontology (Licence: MN R0761352) |
Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: MN R0761352) |
Enumeration Date | 2006-06-29 |
Last Update Date | 2012-06-18 |