| NPI | 1770027138 |
|---|---|
| Entity Type | Individual |
| Gender | N/A |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: NJ 26NJ00685800) |
| Additional Taxonomies | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: PA SP016629) |
| 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: VT 101.0136179) | |
| 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: NY 404506) | |
| 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: CT 10922) | |
| 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: FL 11019410) | |
| Enumeration Date | 2016-12-05 |
| Last Update Date | 2023-05-09 |