| NPI | 1578139671 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: MN 7792) | 
| Additional Taxonomies | 163WP0808X Registered Nurse, Psych/Mental Health (Licence: MN 2010069) | 
| Enumeration Date | 2021-05-28 | 
| Last Update Date | 2023-08-24 |