| NPI | 1962263970 |
|---|---|
| Former Name | BRENT MIKEL LOPEZ |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 163WP0809X Registered Nurse, Psych/Mental Health, Adult (Licence: MI 4704341467) |
| Enumeration Date | 2024-01-17 |
| Last Update Date | 2024-01-17 |