| NPI | 1053726794 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: AZ TAP5663) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: AZ TAP5663) |
| Enumeration Date | 2014-06-20 |
| Last Update Date | 2023-01-13 |