| NPI | 1124218466 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: MI 4704241492) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: MI 4704241492) |
| Enumeration Date | 2007-08-01 |
| Last Update Date | 2022-01-18 |