| NPI | 1356904213 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 163W00000X Registered Nurse (Licence: MI 4704396369) |
| Additional Taxonomies | 106S00000X Behavior Technician |
| Enumeration Date | 2019-04-17 |
| Last Update Date | 2023-06-02 |