| NPI | 1053031310 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: CT 11208) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: NY 698659) |
| 163W00000X Registered Nurse (Licence: CT 129255) | |
| 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: NY 404431) | |
| Enumeration Date | 2022-08-29 |
| Last Update Date | 2022-12-01 |