| NPI | 1699053827 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: MI 1699053827) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: MI 1699053827) |
| Enumeration Date | 2011-07-21 |
| Last Update Date | 2023-06-14 |