| NPI | 1669899704 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MI 4704128505) |
| Additional Taxonomies | 363LP2300X Nurse Practitioner, Primary Care (Licence: MI 4704128505) |
| 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: MI 4704128505) | |
| Enumeration Date | 2014-03-26 |
| Last Update Date | 2023-12-27 |