| NPI | 1548265200 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: CT 002301) |
| Additional Taxonomies | 363LW0102X Nurse Practitioner, Women's Health (Licence: CT 002301) |
| Enumeration Date | 2005-06-17 |
| Last Update Date | 2009-02-12 |