| NPI | 1679041545 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: MI 4704264372) |
| Additional Taxonomies | 163WP0808X Registered Nurse, Psych/Mental Health (Licence: MI 4704264372) |
| Enumeration Date | 2018-11-08 |
| Last Update Date | 2018-12-05 |