| NPI | 1295577039 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: CT 12.013733) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: CT 10.145190) |
| Enumeration Date | 2024-06-12 |
| Last Update Date | 2024-08-24 |