| NPI | 1740267491 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: MN 4365) |
| Additional Taxonomies | 163WP0808X Registered Nurse, Psych/Mental Health (Licence: MN 1193262) |
| Enumeration Date | 2005-12-23 |
| Last Update Date | 2022-01-20 |