| NPI | 1124435276 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: MI 4704264429) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: MI 4704264429) |
| Enumeration Date | 2014-07-21 |
| Last Update Date | 2022-12-20 |