| NPI | 1649495862 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LA2200X Nurse Practitioner Adult Health (Licence: MI 4704085934) |
| Additional Taxonomies | 363LP0808X Nurse Practitioner Psychiatric/Mental Health (Licence: MI 4704085934) |
| Enumeration Date | 2007-04-14 |
| Last Update Date | 2007-07-08 |