| NPI | 1760482327 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner Psychiatric/Mental Health (Licence: AZ AP8175) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: MI 4704126846) |
| 363LP0808X Nurse Practitioner Psychiatric/Mental Health (Licence: MI 4704126846) | |
| 363LF0000X Nurse Practitioner Family (Licence: AZ AP8176) | |
| Enumeration Date | 2005-07-26 |
| Last Update Date | 2015-10-15 |