| NPI | 1740264092 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: PA SP009695) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: PA SP006933B) |
| Enumeration Date | 2005-11-30 |
| Last Update Date | 2010-08-05 |