| NPI | 1629687785 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: MI 4704196169) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: MI 4704196169) |
| Enumeration Date | 2020-07-24 |
| Last Update Date | 2022-07-27 |