NPI | 1871689679 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LG0600X Nurse Practitioner, Gerontology (Licence: CT #002017) |
Additional Taxonomies | 363LA2200X Nurse Practitioner, Adult Health (Licence: CT 002017) |
363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: CT 002017) | |
Enumeration Date | 2006-10-05 |
Last Update Date | 2014-01-07 |