| NPI | 1700294667 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: MN 10262) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: MN 204451-4) |
| Enumeration Date | 2014-07-23 |
| Last Update Date | 2023-09-07 |