| NPI | 1417349754 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: CT 006034) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: CT 094197) |
| 363L00000X Nurse Practitioner (Licence: CT 006034) | |
| Enumeration Date | 2015-02-24 |
| Last Update Date | 2016-09-29 |