| NPI | 1952838997 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: MN 5144) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: MN F05170156) |
| Enumeration Date | 2017-05-22 |
| Last Update Date | 2024-07-01 |