| NPI | 1285150813 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: MN 202004621) |
| Additional Taxonomies | 363LP2300X Nurse Practitioner, Primary Care (Licence: MN 5334) |
| Enumeration Date | 2017-08-15 |
| Last Update Date | 2022-03-14 |