| NPI | 1770055592 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MI 4704354520) |
| Additional Taxonomies | 106S00000X Behavior Technician |
| Enumeration Date | 2018-12-18 |
| Last Update Date | 2024-05-26 |