| NPI | 1083996011 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP0808X Nurse Practitioner Psychiatric/Mental Health (Licence: AZ 280448) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: AZ RN135246) |
| Enumeration Date | 2011-09-15 |
| Last Update Date | 2022-09-07 |