| NPI | 1578578449 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: MN 3417) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: MN R116114-2) |
| Enumeration Date | 2006-07-29 |
| Last Update Date | 2020-12-07 |