| NPI | 1962893776 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: FL APRN11017578) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: MI 4704182411) |
| Enumeration Date | 2015-02-16 |
| Last Update Date | 2022-05-03 |