| NPI | 1104878313 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: MN 2321) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: MN 212432-4) |
| Enumeration Date | 2006-05-16 |
| Last Update Date | 2016-09-08 |