| NPI | 1154063766 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: PA SP026141) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: PA RN583064) |
| Enumeration Date | 2022-04-13 |
| Last Update Date | 2022-10-17 |