| NPI | 1295261451 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MI 4704271315) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: MI 4704271315) |
| 163WP0808X Registered Nurse, Psych/Mental Health (Licence: MI 4704271315) | |
| Enumeration Date | 2017-05-10 |
| Last Update Date | 2018-10-29 |