| NPI | 1053440164 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YP2500X Counselor Professional (Licence: MI 6401008959) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: MI 4704196954) |
| Enumeration Date | 2007-03-05 |
| Last Update Date | 2007-07-08 |