| NPI | 1902411259 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: TX 1075815) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: MI 4704365990) |
| Enumeration Date | 2020-09-14 |
| Last Update Date | 2025-08-01 |