| NPI | 1972164440 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP0808X Nurse Practitioner Psychiatric/Mental Health (Licence: PA SP020996) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: PA RN704665) |
| 363LP0808X Nurse Practitioner Psychiatric/Mental Health (Licence: NJ 26NJ01056800) | |
| Enumeration Date | 2019-06-25 |
| Last Update Date | 2024-08-06 |