| NPI | 1942016803 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: AZ RNP316903) | 
| Additional Taxonomies | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: AZ RNP316903) | 
| Enumeration Date | 2024-12-05 | 
| Last Update Date | 2024-12-05 |