| NPI | 1235836743 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: AZ 294260) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: AZ RN210429) |
| Enumeration Date | 2023-02-14 |
| Last Update Date | 2023-12-08 |