| NPI | 1063598316 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: CT 003947) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: CT R55783) |
| Enumeration Date | 2006-10-30 |
| Last Update Date | 2013-03-04 |