| NPI | 1255679890 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner Psychiatric/Mental Health (Licence: MI 4704279886) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: MI 4704279886) |
| Enumeration Date | 2013-01-16 |
| Last Update Date | 2022-07-20 |