| NPI | 1225454077 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: AZ AP11447) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: TX AP122079) |
| 363LF0000X Nurse Practitioner, Family (Licence: AZ AP10941) | |
| Enumeration Date | 2014-03-17 |
| Last Update Date | 2019-05-01 |