| NPI | 1679104152 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: PA SP021628) |
| Additional Taxonomies | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: PA RN658646) |
| Enumeration Date | 2020-02-03 |
| Last Update Date | 2020-03-05 |