| NPI | 1922526029 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: MI 4704225832) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: MI 4704225832) |
| Enumeration Date | 2017-09-08 |
| Last Update Date | 2019-08-18 |