| NPI | 1952981912 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: AZ 255401) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: AZ 255401) |
| 363LA2200X Nurse Practitioner, Adult Health (Licence: AZ 255401) | |
| Enumeration Date | 2021-04-13 |
| Last Update Date | 2021-04-13 |