| NPI | 1013153626 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: PA SP014223) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: PA RN531625) |
| Enumeration Date | 2009-01-02 |
| Last Update Date | 2017-03-08 |