| NPI | 1104438696 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: PA SP022272) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: PA RN696143) |
| Enumeration Date | 2020-08-18 |
| Last Update Date | 2022-02-01 |