| NPI | 1346663804 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: MI 4704261304) |
| Additional Taxonomies | 163WP0808X Registered Nurse, Psych/Mental Health (Licence: MI 4704261304) |
| Enumeration Date | 2014-02-03 |
| Last Update Date | 2020-01-22 |