| NPI | 1043643992 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: CT 005388) |
| Additional Taxonomies | 363LA2200X Nurse Practitioner, Adult Health (Licence: NY 30306501) |
| 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: NY 405769) | |
| Enumeration Date | 2013-08-14 |
| Last Update Date | 2024-04-16 |