| NPI | 1336115807 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: MI 4704207294) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: MI 4704207294) |
| Enumeration Date | 2006-02-24 |
| Last Update Date | 2023-12-15 |