| NPI | 1649889601 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: CT 10355) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: CT 127925) |
| Enumeration Date | 2020-07-27 |
| Last Update Date | 2022-04-06 |