| NPI | 1184039968 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: AZ AP5635)  | 
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: AZ AP5635)  | 
| Enumeration Date | 2014-06-30 | 
| Last Update Date | 2021-07-19 |