| NPI | 1114298700 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP0808X Nurse Practitioner Psychiatric/Mental Health (Licence: MI 4704259218) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner Family (Licence: MI 4704259218) |
| 363LF0000X Nurse Practitioner Family (Licence: MI F1211051) | |
| Enumeration Date | 2012-01-13 |
| Last Update Date | 2021-09-21 |