| NPI | 1073920203 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: AZ AP11428) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: GA RN201907) |
| Enumeration Date | 2014-07-21 |
| Last Update Date | 2022-02-02 |