| NPI | 1982692232 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP2300X Nurse Practitioner Primary Care (Licence: MN 2385) |
| Additional Taxonomies | 363LG0600X Nurse Practitioner Gerontology (Licence: MN CNP2385) |
| Enumeration Date | 2005-10-11 |
| Last Update Date | 2018-05-10 |