| NPI | 1780914374 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: CT 004289) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: CT 4289) |
| 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: CT 004289) | |
| Enumeration Date | 2010-01-05 |
| Last Update Date | 2024-05-01 |