NPI | 1417217431 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: CT 4916) |
Additional Taxonomies | 163W00000X Registered Nurse (Licence: CT E53483) |
Enumeration Date | 2012-05-23 |
Last Update Date | 2014-02-24 |