| NPI | 1598366767 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: AZ 257004) | 
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: AZ 156927) | 
| Enumeration Date | 2020-11-04 | 
| Last Update Date | 2021-07-29 |