| NPI | 1275429177 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: MN 13391) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: MN 2540593) |
| 163W00000X Registered Nurse (Licence: WI 264136-30) | |
| Enumeration Date | 2025-06-16 |
| Last Update Date | 2025-09-19 |