| NPI | 1558422329 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: MT NUR-APRN-LIC-100479) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: MI 4704173114) |
| 363LF0000X Nurse Practitioner, Family (Licence: MD R185408) | |
| Enumeration Date | 2006-12-13 |
| Last Update Date | 2021-03-18 |