| NPI | 1124764402 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: AZ 283698) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: AZ RN176037) |
| 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: AZ 093870) | |
| Enumeration Date | 2022-05-09 |
| Last Update Date | 2022-12-11 |