| NPI | 1780115345 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: AZ 271514) | 
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: MD R156972) | 
| Enumeration Date | 2017-03-24 | 
| Last Update Date | 2023-03-01 |