| NPI | 1295256378 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP2300X Nurse Practitioner Primary Care (Licence: AZ AP10119) |
| Additional Taxonomies | 363LP0808X Nurse Practitioner Psychiatric/Mental Health (Licence: AZ AP10119) |
| Enumeration Date | 2017-06-29 |
| Last Update Date | 2024-06-03 |