| NPI | 1093760167 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: AZ AP3709) | 
| Additional Taxonomies | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: PA SP009026) | 
| 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: NY 400916) | |
| 363LA2200X Nurse Practitioner, Adult Health (Licence: NY 304376) | |
| Enumeration Date | 2006-05-24 | 
| Last Update Date | 2012-11-08 |