| NPI | 1578076634 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: MD R229598) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: CT 10-131571) |
| 163WP0808X Registered Nurse, Psych/Mental Health (Licence: MD 2017015383) | |
| Enumeration Date | 2017-11-13 |
| Last Update Date | 2023-08-09 |