| NPI | 1780999177 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: MN R155507-5) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: MN 6396) |
| Enumeration Date | 2010-08-10 |
| Last Update Date | 2023-09-27 |