| NPI | 1316219272 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: MI 4704151724) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: MI 4704151724) |
| Enumeration Date | 2012-02-07 |
| Last Update Date | 2017-03-02 |