| NPI | 1134605868 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: AZ AP11552) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: AZ Pending) |
| Enumeration Date | 2018-07-16 |
| Last Update Date | 2021-08-04 |