| NPI | 1164059077 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: AZ 247210) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: AZ RN116360) |
| Enumeration Date | 2020-03-23 |
| Last Update Date | 2021-03-15 |