| NPI | 1518163864 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP0808X Nurse Practitioner Psychiatric/Mental Health (Licence: CT 1054) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner Family (Licence: CT 001054) |
| Enumeration Date | 2007-06-25 |
| Last Update Date | 2018-04-10 |