| NPI | 1104225499 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: MN R156407-9 CNP1972) |
| Additional Taxonomies | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: MN R156407-9) |
| Enumeration Date | 2014-08-22 |
| Last Update Date | 2020-09-23 |