| NPI | 1821497330 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MI 4704285956) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: CO RN.1628095) |
| 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: MI 4704285956) | |
| Enumeration Date | 2014-08-20 |
| Last Update Date | 2018-12-13 |