| NPI | 1245654441 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: MI 4704261537) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: MI 4704261537) |
| Enumeration Date | 2014-02-07 |
| Last Update Date | 2021-04-02 |