| NPI | 1134542343 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: MI 5601012176) |
| Additional Taxonomies | 364SP0808X Clinical Nurse Specialist, Psych/Mental Health (Licence: MI 5601012176) |
| Enumeration Date | 2014-01-23 |
| Last Update Date | 2025-11-08 |