NPI | 1467809236 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MI 4704254106) |
Additional Taxonomies | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: MI 4704254106) |
Enumeration Date | 2016-05-20 |
Last Update Date | 2020-04-22 |