| NPI | 1710373923 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: AZ AP7743) | 
| Additional Taxonomies | 363LP2300X Nurse Practitioner, Primary Care (Licence: AZ AP7743) | 
| Enumeration Date | 2015-04-14 | 
| Last Update Date | 2022-10-18 |