| NPI | 1013364199 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: MN CNP 4630) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: MN R 197063-4) |
| Enumeration Date | 2016-05-19 |
| Last Update Date | 2017-04-26 |