| NPI | 1164509592 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MI 4704233706) |
| Additional Taxonomies | 363LP0808X Nurse Practitioner Psychiatric/Mental Health (Licence: MI 4704233706) |
| Enumeration Date | 2006-11-01 |
| Last Update Date | 2007-12-18 |