| NPI | 1255635058 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: PA SP025505) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: PA SP013428) |
| Enumeration Date | 2011-01-07 |
| Last Update Date | 2024-10-31 |