| NPI | 1346235876 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: MI 4704154954) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: MI 4704154954) |
| Enumeration Date | 2005-09-12 |
| Last Update Date | 2007-08-13 |