| NPI | 1417598079 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: MN 6939) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: WI 251578) |
| 163W00000X Registered Nurse (Licence: MN 2469127) | |
| 363L00000X Nurse Practitioner (Licence: WI 9863) | |
| 363L00000X Nurse Practitioner (Licence: MN 6939) | |
| 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: WI 9863) | |
| Enumeration Date | 2019-10-04 |
| Last Update Date | 2024-08-28 |