| NPI | 1609114768 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MI 4704277843) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: MI 4704277843) |
| 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: MI 4704277843) | |
| Enumeration Date | 2013-01-24 |
| Last Update Date | 2020-12-30 |