| NPI | 1679114805 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner Psychiatric/Mental Health (Licence: MI 4704184714) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner Family (Licence: MI 4704184714) |
| Enumeration Date | 2019-09-29 |
| Last Update Date | 2025-07-16 |