| NPI | 1508295908 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: MI 4704145249) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: MI 4704145249) |
| Enumeration Date | 2013-11-06 |
| Last Update Date | 2016-02-23 |