| NPI | 1538564976 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: CT 8476) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: CT 159912) |
| 163W00000X Registered Nurse (Licence: NY 684851) | |
| 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: NY 402771) | |
| Enumeration Date | 2014-10-28 |
| Last Update Date | 2019-10-04 |