| NPI | 1073256582 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: MN 9129) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: MN 2151070) |
| Enumeration Date | 2022-04-14 |
| Last Update Date | 2022-04-21 |