| NPI | 1639683105 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: AZ 301503) |
| Additional Taxonomies | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: OR 201708006NP-PP) |
| Enumeration Date | 2017-11-20 |
| Last Update Date | 2024-01-16 |