| NPI | 1710694286 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner Psychiatric/Mental Health (Licence: MN 9677) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: MN 2114570) |
| Enumeration Date | 2022-11-03 |
| Last Update Date | 2022-11-10 |