| NPI | 1003199217 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: CT 4798) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: CT 4768) |
| Enumeration Date | 2011-09-23 |
| Last Update Date | 2011-09-23 |