| NPI | 1942801204 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: MI 4704298067) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: MI 4704298067) |
| Enumeration Date | 2020-11-03 |
| Last Update Date | 2023-09-04 |