| NPI | 1053670968 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner Psychiatric/Mental Health (Licence: AZ AP11187) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: AZ 094553) |
| 363LF0000X Nurse Practitioner Family (Licence: AZ AP4605) | |
| 363LP2300X Nurse Practitioner Primary Care (Licence: AZ AP4605) | |
| Enumeration Date | 2012-05-11 |
| Last Update Date | 2019-08-08 |