| NPI | 1699723502 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: MN R212277-9) |
| Additional Taxonomies | 163WP0808X Registered Nurse, Psych/Mental Health (Licence: ID NP-744A) |
| Enumeration Date | 2006-05-04 |
| Last Update Date | 2017-03-08 |