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