| NPI | 1336682947 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MN CNP4890) |
| Additional Taxonomies | 363LP0808X Nurse Practitioner Psychiatric/Mental Health (Licence: MN CNP4890) |
| Enumeration Date | 2016-11-30 |
| Last Update Date | 2021-04-05 |