| NPI | 1427480474 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: MN R-163053-4) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: MN R-163053-4) |
| Enumeration Date | 2013-08-01 |
| Last Update Date | 2020-09-17 |