| NPI | 1154982346 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: MI 4704368516) |
| Additional Taxonomies | 163WP0808X Registered Nurse, Psych/Mental Health (Licence: NH 080450-21) |
| 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: NH 080450-23) | |
| Enumeration Date | 2019-06-27 |
| Last Update Date | 2021-02-11 |