| NPI | 1902963325 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: CT 992) |
| Additional Taxonomies | 363LA2200X Nurse Practitioner, Adult Health (Licence: CT 000992) |
| Enumeration Date | 2007-01-03 |
| Last Update Date | 2021-07-16 |