| NPI | 1285038299 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: MN 11266) | 
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: KS 53-76434-072) | 
| Enumeration Date | 2014-10-20 | 
| Last Update Date | 2024-03-11 |