| NPI | 1518246214 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: AZ AP5107) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: AZ 187744) |
| 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: AZ 2021015366) | |
| Enumeration Date | 2011-08-11 |
| Last Update Date | 2024-09-15 |