| NPI | 1669130381 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: FL 9475967) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: MI 4704318940) |
| 163W00000X Registered Nurse (Licence: FL 9475967) | |
| Enumeration Date | 2021-11-30 |
| Last Update Date | 2022-07-28 |