| NPI | 1144625799 |
|---|---|
| Former Name | SANDRA BOSHKO |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner Psychiatric/Mental Health (Licence: AZ 296854) |
| Additional Taxonomies | 363LP0808X Nurse Practitioner Psychiatric/Mental Health (Licence: NJ 26NJ00528400) |
| Enumeration Date | 2014-10-24 |
| Last Update Date | 2023-09-13 |