| NPI | 1316405996 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP0808X Nurse Practitioner Psychiatric/Mental Health (Licence: MI 4704263793) |
| Additional Taxonomies | 363LP0808X Nurse Practitioner Psychiatric/Mental Health (Licence: FL APRN11007252) |
| 363LF0000X Nurse Practitioner Family (Licence: FL APRN11007252) | |
| 363LF0000X Nurse Practitioner Family (Licence: MI 4704263793) | |
| Enumeration Date | 2019-03-04 |
| Last Update Date | 2024-05-02 |