| NPI | 1205371093 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: CT 013453) |
| Additional Taxonomies | 164W00000X Licensed Practical Nurse (Licence: NY 327010-1) |
| Enumeration Date | 2017-01-03 |
| Last Update Date | 2024-07-11 |