| NPI | 1831929108 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MI 4704313838) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: MI 4704313838) |
| 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: MI 46704313838) | |
| Enumeration Date | 2024-08-02 |
| Last Update Date | 2025-01-27 |