| NPI | 1265294417 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: MN 12520) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: WI 244752-30) |
| 163W00000X Registered Nurse (Licence: MN 1915385) | |
| Enumeration Date | 2024-01-24 |
| Last Update Date | 2025-08-07 |