| NPI | 1174893879 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: MN 7756) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: ND 31131) |
| 363LF0000X Nurse Practitioner, Family (Licence: MN 7756) | |
| Enumeration Date | 2012-01-11 |
| Last Update Date | 2023-01-04 |