| NPI | 1164818357 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: CT 006093) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: CT 006093) |
| Enumeration Date | 2015-04-14 |
| Last Update Date | 2018-03-17 |