| NPI | 1699905604 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: MN 5163) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: NY 382314) |
| 363L00000X Nurse Practitioner (Licence: MN 5163) | |
| 363LP0200X Nurse Practitioner, Pediatrics (Licence: IL 209007674) | |
| Enumeration Date | 2009-07-24 |
| Last Update Date | 2023-12-07 |