| NPI | 1174077192 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: MI 4704355404) |
| Additional Taxonomies | 164W00000X Licensed Practical Nurse (Licence: MI 4703116307) |
| Enumeration Date | 2016-08-08 |
| Last Update Date | 2025-09-30 |