| NPI | 1699044818 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 364SP0807X Clinical Nurse Specialist Psychiatric/Mental Health, Child & Adolescent (Licence: MN R84342-9) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: MN R84342-9) |
| 163W00000X Registered Nurse (Licence: MI 4704231296) | |
| 363LP0808X Nurse Practitioner Psychiatric/Mental Health (Licence: MI 4704231296) | |
| Enumeration Date | 2011-12-16 |
| Last Update Date | 2014-10-24 |