| NPI | 1558712661 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner Psychiatric/Mental Health (Licence: MN CNP 4726) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: CT 118953) |
| 163W00000X Registered Nurse (Licence: MN 237656-7) | |
| 363L00000X Nurse Practitioner (Licence: MN 4726) | |
| Enumeration Date | 2016-06-29 |
| Last Update Date | 2024-03-22 |