| NPI | 1558410787 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: MI 4704240933)  | 
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: MI 4704240933)  | 
| Enumeration Date | 2007-01-09 | 
| Last Update Date | 2022-02-28 |