| NPI | 1174774061 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: NJ 26NJ00707600) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: NJ 26NJ00707600) |
| 363LF0000X Nurse Practitioner, Family (Licence: PA SP00425B) | |
| 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: PA SP004252B) | |
| Enumeration Date | 2008-10-09 |
| Last Update Date | 2020-07-08 |