| NPI | 1134360092 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: MI 4704217251) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: NC 193810) |
| 163W00000X Registered Nurse (Licence: CO RN.1636108) | |
| Enumeration Date | 2009-03-23 |
| Last Update Date | 2020-04-30 |