| NPI | 1154658961 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: CT 005740) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: FL 9181653) |
| Enumeration Date | 2009-11-16 |
| Last Update Date | 2017-05-03 |