| NPI | 1285075788 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: CT 005395) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: CT 5395) |
| 363L00000X Nurse Practitioner (Licence: MN r231776-2) | |
| Enumeration Date | 2013-07-12 |
| Last Update Date | 2016-08-17 |