| NPI | 1578620506 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: PA SP010882) |
| Additional Taxonomies | 101Y00000X Counselor |
| 363LA2200X Nurse Practitioner, Adult Health (Licence: PA SP009534) | |
| Enumeration Date | 2007-01-02 |
| Last Update Date | 2014-10-17 |