| NPI | 1487262390 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: NC 5020300) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: CT 153282) |
| 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: CT 9125) | |
| Enumeration Date | 2020-07-16 |
| Last Update Date | 2024-09-05 |