| NPI | 1194378117 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: MN 6721) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: MN 6721) |
| 363LP2300X Nurse Practitioner, Primary Care (Licence: MN 6721) | |
| Enumeration Date | 2019-07-18 |
| Last Update Date | 2023-06-07 |