| NPI | 1184857021 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner Psychiatric/Mental Health (Licence: MN CNP 2762) |
| Additional Taxonomies | 363LP0808X Nurse Practitioner Psychiatric/Mental Health (Licence: MN R 137326-0) |
| Enumeration Date | 2009-08-26 |
| Last Update Date | 2016-01-13 |