| NPI | 1972843126 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: MI 4704131775) | 
| Additional Taxonomies | 163WP0808X Registered Nurse, Psych/Mental Health (Licence: GA RN250274) | 
| Enumeration Date | 2013-02-26 | 
| Last Update Date | 2023-07-14 |