| NPI | 1972941672 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 163W00000X Registered Nurse (Licence: MI 4704232445) |
| Additional Taxonomies | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: MI 4704232445) |
| Enumeration Date | 2013-06-05 |
| Last Update Date | 2019-07-16 |