| NPI | 1609279058 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: PA SP014251) |
| Additional Taxonomies | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: NJ 26NJ01285100) |
| 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: FL TPAN223) | |
| Enumeration Date | 2014-09-30 |
| Last Update Date | 2024-08-06 |