NPI | 1578297313 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LG0600X Nurse Practitioner, Gerontology (Licence: PA SP023351) |
Additional Taxonomies | 363LG0600X Nurse Practitioner, Gerontology (Licence: FL APRN11017838) |
363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: PA PMH04250056) | |
Enumeration Date | 2022-07-15 |
Last Update Date | 2025-06-04 |