| NPI | 1992399653 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: MN 9652) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: MN 2466245) |
| 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: IA G170528) | |
| Enumeration Date | 2021-02-23 |
| Last Update Date | 2022-11-14 |