| NPI | 1306497870 |
|---|---|
| Former Name | SANDRA C ELIJAH |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner Psychiatric/Mental Health (Licence: MD R217264) |
| Enumeration Date | 2019-09-25 |
| Last Update Date | 2019-09-25 |