| NPI | 1891229654 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: PA SP024592) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: PA RN661863) |
| 363L00000X Nurse Practitioner (Licence: PA SP024592) | |
| Enumeration Date | 2017-04-18 |
| Last Update Date | 2023-12-11 |