| NPI | 1184974552 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: MN R-138001-7) |
| Additional Taxonomies | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: MN R-138-001-7) |
| Enumeration Date | 2012-09-13 |
| Last Update Date | 2018-11-27 |