| NPI | 1992816797 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner Psychiatric/Mental Health (Licence: MI 4704203745) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: MI 4704203745) |
| 363LA2200X Nurse Practitioner Adult Health (Licence: MI 4704203745) | |
| Enumeration Date | 2006-08-31 |
| Last Update Date | 2014-04-10 |