| NPI | 1760278048 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MI 4704339547) |
| Additional Taxonomies | 163WP0808X Registered Nurse, Psych/Mental Health (Licence: MI 4704339547) |
| Enumeration Date | 2025-04-15 |
| Last Update Date | 2025-04-15 |