| NPI | 1003481847 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: AZ 257625) |
| Additional Taxonomies | 207QA0505X Family Medicine, Adult Medicine (Licence: AZ 257625) |
| Enumeration Date | 2021-05-24 |
| Last Update Date | 2023-11-30 |