| NPI | 1962814905 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MN 4151) |
| Additional Taxonomies | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: MN R 113583-5) |
| 364SP0807X Clinical Nurse Specialist, Psych/Mental Health, Child & Adolescent (Licence: MN R 113583-5) | |
| Enumeration Date | 2014-05-26 |
| Last Update Date | 2024-01-16 |