| NPI | 1093999526 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: AZ 238698) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: KY 5403P) |
| 363LF0000X Nurse Practitioner, Family (Licence: AK 1244) | |
| Enumeration Date | 2007-12-19 |
| Last Update Date | 2023-03-07 |