| NPI | 1700284106 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: CT 005982) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: CT 76177) |
| Enumeration Date | 2014-12-17 |
| Last Update Date | 2015-06-30 |