| NPI | 1386304954 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: NY 403916) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: TX 1113638) |
| 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: TX 1113638) | |
| 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: CT 11186) | |
| 163W00000X Registered Nurse (Licence: NY 755489) | |
| 163W00000X Registered Nurse (Licence: CT 199669) | |
| Enumeration Date | 2021-12-23 |
| Last Update Date | 2024-04-02 |