| NPI | 1265739833 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: MI 4704270299) |
| Additional Taxonomies | 163WP0809X Registered Nurse, Psych/Mental Health, Adult (Licence: MI 4704270299) |
| Enumeration Date | 2011-02-17 |
| Last Update Date | 2013-04-15 |