| NPI | 1801343843 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: MN CNP4931) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: MD R202065) |
| 363LF0000X Nurse Practitioner, Family (Licence: MN CNP4931) | |
| Enumeration Date | 2016-09-07 |
| Last Update Date | 2022-08-31 |