| NPI | 1215462411 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: PA SP029605) |
| Additional Taxonomies | 163WR0006X Registered Nurse, Registered Nurse First Assistant (Licence: PA RN582342) |
| 363LA2200X Nurse Practitioner, Adult Health (Licence: PA SP017441) | |
| Enumeration Date | 2017-04-25 |
| Last Update Date | 2025-10-25 |