| NPI | 1720410855 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: AZ AP10250) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: MI 4704277591) |
| Enumeration Date | 2013-07-31 |
| Last Update Date | 2023-06-19 |