| NPI | 1003359738 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: CT 6862) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: CT 6862) |
| 363LF0000X Nurse Practitioner, Family (Licence: CT 6862) | |
| 363LF0000X Nurse Practitioner, Family (Licence: WV APRN82555-NP-C) | |
| 363LF0000X Nurse Practitioner, Family (Licence: KY 3010914) | |
| Enumeration Date | 2016-11-29 |
| Last Update Date | 2019-11-15 |