NPI | 1013295575 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: CT 5060) |
Additional Taxonomies | 163W00000X Registered Nurse (Licence: CT 074795) |
Enumeration Date | 2011-08-01 |
Last Update Date | 2013-01-31 |