| NPI | 1568855054 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: MN 3753) |
| Additional Taxonomies | 363LA2200X Nurse Practitioner, Adult Health (Licence: MN 3753) |
| Enumeration Date | 2015-03-09 |
| Last Update Date | 2020-12-07 |