| NPI | 1972025161 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LG0600X Nurse Practitioner, Gerontology (Licence: MN 5249) |
| Additional Taxonomies | 363LA2200X Nurse Practitioner, Adult Health (Licence: MN 5249) |
| Enumeration Date | 2017-07-10 |
| Last Update Date | 2017-07-10 |