| NPI | 1225724834 |
|---|---|
| Former Name | IRENE GOODYKE |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 163WA0400X Registered Nurse, Addiction (Substance Use Disorder) (Licence: MI 4704360410) |
| Enumeration Date | 2023-04-17 |
| Last Update Date | 2023-04-17 |