| NPI | 1043624810 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: MI 4704272553) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: MI 4704272553) |
| Enumeration Date | 2014-06-19 |
| Last Update Date | 2016-05-13 |