| NPI | 1700199502 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner Psychiatric/Mental Health (Licence: MI 4704244497) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: MI 4704244497) |
| Enumeration Date | 2010-07-21 |
| Last Update Date | 2013-05-13 |