| NPI | 1710597422 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: NJ 26NJ01046400) |
| Additional Taxonomies | 163WP0808X Registered Nurse, Psych/Mental Health (Licence: NJ 26NR18141000) |
| Enumeration Date | 2020-08-06 |
| Last Update Date | 2021-12-29 |