| NPI | 1083147219 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: CT 12.006985) |
| Additional Taxonomies | 363LA2200X Nurse Practitioner, Adult Health (Licence: AZ 242355) |
| 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: AZ 242355) | |
| 363LA2200X Nurse Practitioner, Adult Health (Licence: CT 12.006985) | |
| Enumeration Date | 2017-04-05 |
| Last Update Date | 2022-06-28 |