| NPI | 1639395395 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: PA TP006931C) |
| Additional Taxonomies | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: PA SP009838) |
| 2084N0600X (Licence: PA SP009838) | |
| Enumeration Date | 2007-04-18 |
| Last Update Date | 2015-05-28 |