| NPI | 1821264045 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: PA 026002) |
| Additional Taxonomies | 363LP0200X Nurse Practitioner, Pediatrics (Licence: PA 007893) |
| 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: PA Sp026002) | |
| Enumeration Date | 2008-05-07 |
| Last Update Date | 2025-08-11 |