| NPI | 1902160476 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: MN R-172201-5) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: MN 1081) |
| Enumeration Date | 2012-06-29 |
| Last Update Date | 2018-04-26 |