| NPI | 1588321020 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: MI 4704201067) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: MI 4704201067) |
| Enumeration Date | 2021-11-18 |
| Last Update Date | 2025-10-01 |