| NPI | 1528604972 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: CT 9684) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: NY 658864) |
| 363LA2200X Nurse Practitioner, Adult Health (Licence: NY F309392-01) | |
| Enumeration Date | 2019-11-20 |
| Last Update Date | 2022-08-09 |