| NPI | 1669042990 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: MI 2021035112) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: MI 4704326670) |
| Enumeration Date | 2021-06-29 |
| Last Update Date | 2025-04-23 |