| NPI | 1235712530 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: NJ 26NJ01134100) |
| Additional Taxonomies | 2084A0401X Psychiatry & Neurology, Addiction Medicine (Licence: DE L8-0010492) |
| 2084P0802X Psychiatry & Neurology, Addiction Psychiatry (Licence: PA SP024403) | |
| Enumeration Date | 2021-05-04 |
| Last Update Date | 2024-01-08 |