| NPI | 1669150223 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 164W00000X Licensed Practical Nurse (Licence: MI 4703083772) |
| Additional Taxonomies | 207RA0401X Internal Medicine, Addiction Medicine (Licence: MI 4703083772) |
| Enumeration Date | 2023-07-05 |
| Last Update Date | 2023-07-05 |