| NPI | 1396081162 |
|---|---|
| Professional Name | N/A N/A N/A |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: CT 005094) |
| Additional Taxonomies | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: CT 005094) |
| Enumeration Date | 2012-12-21 |
| Last Update Date | 2023-05-10 |