| NPI | 1144591793 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: PA SP017895) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: PA RN584906) |
| 363LF0000X Nurse Practitioner, Family (Licence: PA SP011913) | |
| Enumeration Date | 2012-01-13 |
| Last Update Date | 2018-01-04 |