| 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 |