| NPI | 1124783006 |
|---|---|
| Former Name | ABIGAIL KOSTRIVAS |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner Psychiatric/Mental Health (Licence: WI 11520-33) |
| Enumeration Date | 2021-11-04 |
| Last Update Date | 2022-08-29 |