| NPI | 1417010257 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 364SP0807X Clinical Nurse Specialist, Psych/Mental Health, Child & Adolescent (Licence: MN R126869-2) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: MN R1268692) |
| 363L00000X Nurse Practitioner (Licence: MN R126869-2) | |
| Enumeration Date | 2006-12-19 |
| Last Update Date | 2021-05-14 |