| NPI | 1982376968 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: MN 10627) |
| Additional Taxonomies | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: FL APRN11015720) |
| 163W00000X Registered Nurse (Licence: FL RN9381520) | |
| Enumeration Date | 2021-09-29 |
| Last Update Date | 2024-02-12 |