| NPI | 1790010361 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 364SP0807X Clinical Nurse Specialist, Psych/Mental Health, Child & Adolescent (Licence: MN 2009006820) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: MN R 1333860-0) |
| Enumeration Date | 2009-10-15 |
| Last Update Date | 2012-10-05 |