| NPI | 1336405059 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: MI 4704248128) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: MI 4704248128) |
| 363LA2200X Nurse Practitioner, Adult Health (Licence: MI 4704248128) | |
| Enumeration Date | 2012-04-06 |
| Last Update Date | 2024-05-09 |