| NPI | 1972687234 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MN 2995) | 
| Additional Taxonomies | 363LG0600X Nurse Practitioner, Gerontology (Licence: MN R 152832-9) | 
| 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: MN 2995) | |
| Enumeration Date | 2006-10-24 | 
| Last Update Date | 2021-09-07 |