| NPI | 1962380865 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: MN 13277) |
| Additional Taxonomies | 363LP0200X Nurse Practitioner, Pediatrics (Licence: MN 13277) |
| Enumeration Date | 2025-08-26 |
| Last Update Date | 2025-08-26 |