| NPI | 1255573424 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: CT 004057) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner Family (Licence: CT 004057) |
| 363LP0808X Nurse Practitioner Psychiatric/Mental Health (Licence: CT 004057) | |
| Enumeration Date | 2009-04-02 |
| Last Update Date | 2020-04-16 |