| NPI | 1629418041 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: MI 4704255922) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: MI 4704255922) |
| Enumeration Date | 2013-06-29 |
| Last Update Date | 2025-11-22 |