| NPI | 1164888202 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: CT 7366) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: NY 705497) |
| 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: NY 402303) | |
| Enumeration Date | 2016-01-05 |
| Last Update Date | 2021-10-06 |