| NPI | 1376253484 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP0808X Nurse Practitioner Psychiatric/Mental Health (Licence: CT 12290) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: TN 266247) |
| Enumeration Date | 2022-11-29 |
| Last Update Date | 2023-10-20 |