| NPI | 1235620527 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: FL APRN11000203) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: MI 4704247506) |
| 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: MI 18312081156) | |
| Enumeration Date | 2018-05-23 |
| Last Update Date | 2021-04-05 |