| NPI | 1689317695 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: CT 010813) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: MA 2364237) |
| 163W00000X Registered Nurse (Licence: CT 173412) | |
| Enumeration Date | 2022-04-18 |
| Last Update Date | 2023-10-16 |