| NPI | 1477038560 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: MN 9394) |
| Additional Taxonomies | 163WC1500X Registered Nurse, Community Health (Licence: MN 206130-6) |
| Enumeration Date | 2018-09-25 |
| Last Update Date | 2022-08-31 |