| NPI | 1902201155 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: MN 3412) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: MN 3412) |
| Enumeration Date | 2014-10-30 |
| Last Update Date | 2026-09-24 |