| NPI | 1659477784 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: MN 14355) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: MN R0679334) |
| Enumeration Date | 2006-09-16 |
| Last Update Date | 2007-08-03 |