| NPI | 1487045753 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: MI 4704309686) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: MI 4704309686) |
| Enumeration Date | 2015-02-09 |
| Last Update Date | 2022-11-10 |