| NPI | 1902583628 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: NJ 26NJ15091000) |
| Additional Taxonomies | 163WP0808X Registered Nurse, Psych/Mental Health (Licence: PA RN700815) |
| 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: PA SP029459) | |
| Enumeration Date | 2023-07-04 |
| Last Update Date | 2024-06-25 |