| NPI | 1194050187 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: CT 008201) |
| Additional Taxonomies | 104100000X Social Worker |
| 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: MA RN2290632) | |
| Enumeration Date | 2009-10-08 |
| Last Update Date | 2019-09-15 |