| NPI | 1790320372 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: MN 7058) |
| Additional Taxonomies | 163WP0808X Registered Nurse, Psych/Mental Health (Licence: MN R-232337-4) |
| Enumeration Date | 2019-11-07 |
| Last Update Date | 2025-07-21 |