| NPI | 1538294160 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MI 4704137985) |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: MI 6301006224) |
| Enumeration Date | 2007-02-22 |
| Last Update Date | 2009-03-13 |