| NPI | 1508306044 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: MN 5044) |
| Additional Taxonomies | 363LP0200X Nurse Practitioner, Pediatrics (Licence: MN R2052469-8) |
| Enumeration Date | 2017-03-02 |
| Last Update Date | 2024-11-06 |