| NPI | 1104832401 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: CT 001323) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: CT E33733) |
| 163WP0809X Registered Nurse, Psych/Mental Health, Adult (Licence: MA 2264001) | |
| Enumeration Date | 2006-07-31 |
| Last Update Date | 2017-03-20 |