NPI | 1124447024 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LP2300X Nurse Practitioner, Primary Care (Licence: PA SP014867) |
Additional Taxonomies | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: NJ 26NJ00569000) |
Enumeration Date | 2014-04-08 |
Last Update Date | 2024-04-02 |