| NPI | 1306094396 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: CT 001788) |
| Additional Taxonomies | 167G00000X Licensed Psychiatric Technician (Licence: CT E47031) |
| Enumeration Date | 2008-09-03 |
| Last Update Date | 2008-09-03 |