| NPI | 1518702018 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MI 4704375007) |
| Additional Taxonomies | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: OH APRN.CNP.0036722) |
| Enumeration Date | 2024-06-26 |
| Last Update Date | 2025-04-10 |