NPI | 1124323878 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: CT 004587) |
Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: CT 004587) |
Enumeration Date | 2011-01-11 |
Last Update Date | 2016-06-13 |