| NPI | 1639648546 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner Psychiatric/Mental Health (Licence: CT 7969) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: MA RN2300629) |
| 363LF0000X Nurse Practitioner Family (Licence: CT 7969) | |
| Enumeration Date | 2018-11-20 |
| Last Update Date | 2023-04-07 |