| NPI | 1770891509 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP0808X Nurse Practitioner Psychiatric/Mental Health (Licence: MN 2010009064) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: MN R177393-8) |
| Enumeration Date | 2010-09-14 |
| Last Update Date | 2011-04-18 |