| NPI | 1730829391 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: CT 13671)  | 
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: CT 88429)  | 
| Enumeration Date | 2022-03-31 | 
| Last Update Date | 2024-09-17 |