| NPI | 1275758971 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: AZ AP2469) |
| Additional Taxonomies | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: MI 4704203251) |
| 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: MI 4704203251) | |
| 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: AZ 140834) | |
| Enumeration Date | 2007-04-16 |
| Last Update Date | 2010-04-08 |