| NPI | 1366047250 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: MI 2022064500) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: MI 4704348939) |
| Enumeration Date | 2020-12-01 |
| Last Update Date | 2024-04-03 |