| NPI | 1710540372 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: MI 4704303353NSA230AM) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: MI 4704303553) |
| Enumeration Date | 2019-04-19 |
| Last Update Date | 2023-06-04 |