| NPI | 1164836565 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: AZ AP8203) |
| Additional Taxonomies | 363LC1500X Nurse Practitioner, Community Health (Licence: CO APN.0000203) |
| Enumeration Date | 2014-06-13 |
| Last Update Date | 2018-02-16 |