| NPI | 1770868085 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: CT 4844) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: CT 4844) |
| Enumeration Date | 2011-10-18 |
| Last Update Date | 2015-07-04 |