| NPI | 1104485671 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: PA SP025529) |
| Additional Taxonomies | 363LG0600X Nurse Practitioner, Gerontology (Licence: PA SP020315) |
| 363LA2200X Nurse Practitioner, Adult Health (Licence: PA SP020315) | |
| Enumeration Date | 2019-06-10 |
| Last Update Date | 2023-07-05 |