| NPI | 1114462751 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: CT 6900) |
| Additional Taxonomies | 2084A0401X Psychiatry & Neurology, Addiction Medicine (Licence: CT 6900) |
| 363LF0000X Nurse Practitioner, Family (Licence: CT 6900) | |
| Enumeration Date | 2017-01-05 |
| Last Update Date | 2020-04-10 |