| NPI | 1033996764 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: CT 13370) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: CT 192565) |
| 163W00000X Registered Nurse (Licence: MA 2358817) | |
| Enumeration Date | 2023-09-14 |
| Last Update Date | 2024-07-29 |