| NPI | 1003563446 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: MN 9442) |
| Additional Taxonomies | 163WP0808X Registered Nurse, Psych/Mental Health (Licence: MN R202377-1) |
| Enumeration Date | 2022-03-06 |
| Last Update Date | 2022-08-24 |