| NPI | 1104276070 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: MN 10672) |
| Additional Taxonomies | 163WC1500X Registered Nurse, Community Health (Licence: MN R-196969-0) |
| Enumeration Date | 2016-06-21 |
| Last Update Date | 2023-10-13 |