| NPI | 1336723378 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: MN 8167) | 
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: MN 2335508) | 
| Enumeration Date | 2021-05-06 | 
| Last Update Date | 2021-05-06 |