| NPI | 1023622594 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: PA SP022634) |
| Additional Taxonomies | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: NY 403164) |
| 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: PA MF6164228) | |
| Enumeration Date | 2020-09-02 |
| Last Update Date | 2022-02-11 |