| NPI | 1659622959 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: IN 71005192A) |
| Additional Taxonomies | 363LA2200X Nurse Practitioner, Adult Health (Licence: MI 4704273887) |
| 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: IN 71005192A) | |
| Enumeration Date | 2012-09-26 |
| Last Update Date | 2021-09-20 |