| NPI | 1194132233 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: FL 9388499) |
| Additional Taxonomies | 363LA2200X Nurse Practitioner, Adult Health (Licence: MI 4704276952) |
| 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: FL APRN9388499) | |
| Enumeration Date | 2014-07-21 |
| Last Update Date | 2023-05-01 |