| NPI | 1710231899 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: MA RN2343111) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: MI 4704298578) |
| 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: PA SP012440) | |
| Enumeration Date | 2012-10-29 |
| Last Update Date | 2022-09-28 |