| NPI | 1003539842 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 364SP0808X Clinical Nurse Specialist, Psych/Mental Health (Licence: AZ 9400) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: AZ 9400) |
| Enumeration Date | 2022-09-26 |
| Last Update Date | 2023-11-06 |