| NPI | 1639877640 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: AZ 295354) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: AZ RN159980) |
| Enumeration Date | 2023-02-20 |
| Last Update Date | 2023-07-26 |