| NPI | 1306498936 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: MI 4704307530) |
| Additional Taxonomies | 163WA0400X Registered Nurse, Addiction (Substance Use Disorder) (Licence: MI 4704307530) |
| 163WP0808X Registered Nurse, Psych/Mental Health (Licence: MI 4704307530) | |
| Enumeration Date | 2019-07-13 |
| Last Update Date | 2021-05-10 |