| NPI | 1457142069 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: MI 2025000785) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: MI 4704358831) |
| 163WM0705X Registered Nurse, Medical-Surgical (Licence: MI 83186615) | |
| Enumeration Date | 2025-05-14 |
| Last Update Date | 2025-10-17 |