| NPI | 1902044308 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: MI 4704087494) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: MI 363LP0808X) |
| Enumeration Date | 2009-01-23 |
| Last Update Date | 2022-06-08 |