| NPI | 1932791654 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: PA 2023204732) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: PA SP023195) |
| Enumeration Date | 2021-02-04 |
| Last Update Date | 2024-10-23 |