| NPI | 1972916377 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LG0600X Nurse Practitioner Gerontology (Licence: MN 1087) |
| Additional Taxonomies | 363LG0600X Nurse Practitioner Gerontology (Licence: MN R 195539-0) |
| Enumeration Date | 2014-06-04 |
| Last Update Date | 2018-03-26 |