| NPI | 1104284827 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MI 4704619371) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: MI 4704619371) |
| 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: MI 4704319371) | |
| Enumeration Date | 2016-02-09 |
| Last Update Date | 2024-08-06 |