| NPI | 1457753295 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: MN CNP3914) |
| Additional Taxonomies | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: MN 2014011459) |
| Enumeration Date | 2014-09-24 |
| Last Update Date | 2023-05-25 |