| NPI | 1417494998 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: MN CNP4983) |
| Additional Taxonomies | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: MN CNP4983) |
| Enumeration Date | 2017-01-23 |
| Last Update Date | 2026-05-06 |