| NPI | 1689942559 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner Psychiatric/Mental Health (Licence: CT 4972) |
| Additional Taxonomies | 163WP0807X Registered Nurse Psychiatric/Mental Health, Child & Adolescent (Licence: CT 080168) |
| Enumeration Date | 2011-12-07 |
| Last Update Date | 2012-04-11 |