| NPI | 1659503506 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MN 2009006246) |
| Additional Taxonomies | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: MN R 153275-5) |
| Enumeration Date | 2009-08-11 |
| Last Update Date | 2021-03-11 |