| NPI | 1780090951 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: MI 4704274121) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: MI 4704274121) |
| Enumeration Date | 2014-07-08 |
| Last Update Date | 2023-02-17 |