| NPI | 1831219294 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: CT 003297) |
| Additional Taxonomies | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: CT 003297) |
| Enumeration Date | 2007-03-30 |
| Last Update Date | 2017-01-25 |