| NPI | 1003056888 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: PA SP024568) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: NY 5727171) |
| Enumeration Date | 2009-03-06 |
| Last Update Date | 2024-02-05 |